When your fish has ich, you want the thing that actually works, without guesswork. Whether you call it ich or ick, treatment comes down to the same short list: a dedicated antiparasitic medication, dosed to your real water volume and repeated across the parasite's life cycle. This is an honest, tight shortlist of what's worth buying — and what to ignore.
How to read this page
This is guidance first — recommendations are based on what the products contain, how they're dosed, and what's legal where you live. Nothing here is sponsored. Doses quoted are transcribed from the manufacturers' own labels and cited; always follow the current bottle label and dose from your tank's true volume.
The short answer
For almost everyone, the best ich treatment is a dedicated formalin/malachite-green medication — Ich-X being the reliable default — used at its label dose, repeated with water changes until the life cycle breaks. If you just want the best ich medication to order tonight, that's the first pick below. Faunamor, the first FDA-legal ich drug, is an equally sound choice and the one to pick if you want an officially reviewed product. Aquarium salt and heat are supports, not the core, and antibiotics have no place here at all.
The picks
Quick comparison
| Treatment | What it is | How it's dosed | Best for |
|---|---|---|---|
| Ich-X | Formalin + malachite green | ~1 tsp (5 mL) per 10 gal, repeated | The dependable everyday default |
| Faunamor | FDA-indexed antiparasitic (methylene blue, malachite green, acriflavine) | Per bottle label / schedule | Wanting an officially reviewed drug |
| Aquarium salt | Sodium chloride | By concentration; species-dependent | Salt-tolerant or hospital tanks only |
How I chose
Three things separate a good ich treatment from a bad bet:
It targets the parasite, legally. Ich is a protozoan, so the treatment has to be antiparasitic — and in the US it has to be legal. Ich-X (a formalin/malachite-green formulation) and Faunamor (FDA-indexed in April 2025 as the only legal ich drug) both qualify. Antibiotics don't treat parasites and are illegal to market for ornamental fish here, so they're off the list.
It's dosed by volume and repeated. Because only the free-swimming stage of ich can be killed, any treatment has to be applied repeatedly across the life cycle — the University of Florida is clear that a single dose won't do it. Products with a clear per-volume label dose make that easy to get right.
It's honest about collateral damage. The reason I rank salt below the dedicated medications is that salt harms scaleless fish and plants — a treatment that hurts the bystanders isn't the best choice for a typical community tank.
Free tool
Every option here is dosed by actual water volume — calculate the real number before you buy or measure, so a bottle lasts and a dose is safe.
Aquarium volume calculator →Each pick, honestly
Ich-X — best overall. A concentrated formalin and malachite-green formula based on the well-known Leteux-Meyer formulation. It's effective, easy to find, and simple to dose — Hikari's data sheet lists 1 teaspoon (~5 mL) per 10 gallons, after a water change, repeated as directed. Cons: it stains silicone, decor and hands (wear gloves), you must remove carbon, and its label says don't combine it with other treatments including salt. Used on its own and dosed right, it's the dependable choice.
Faunamor — the FDA-legal option. In April 2025 the FDA added Faunamor to its index of legally marketed drugs for minor species, making it the only legal ich drug on the US market. It's an over-the-counter immersion treatment reviewed by a qualified expert panel. Cons: it's newer and can be harder to find than Ich-X, and it comes in small (20 mL / 100 mL) bottles. If official review reassures you, this is the pick — follow its bottle schedule exactly.
Aquarium salt — a support, not a default. Salt is cheap and genuinely works against the free-swimming stage, and in a bare hospital tank with salt-tolerant fish it's a fine tool. Cons: scaleless fish and plants tolerate it poorly, so it's a poor fit for a mixed community tank, and it shouldn't be run alongside Ich-X. Reach for it deliberately, not by default. My aquarium salt guide covers exact dosing and exactly where salt helps.
If you're in the UK
This list is written for the US market — Ich-X and Faunamor aren't sold or legal to advertise the same way in the UK. See my dedicated UK ich treatment shortlist for the products actually available there, including the one used on my own tank.
What to skip
- Antibiotics / "fish antibiotics." Ich is a parasite; antibiotics do nothing for it, and they're illegal to market for ornamental fish in the US. Skip them entirely.
- Reef/marine "ich" treatments for a freshwater tank — marine white spot is a different parasite and a different product.
- Stacking medications. More is not better. One correct antiparasitic, dosed to volume and repeated, clears ich. Combining products raises the risk to your fish without clearing the parasite any faster.
Put it to work
Buying the right bottle is step one; using it correctly is what actually cures the fish. Start with how to treat ich for the full protocol, confirm you're dealing with ich and not velvet, and if you've got a betta or goldfish specifically, see betta ich and goldfish ich.