betta pimple

Question
hello Brittany

my gorgeous red betta has a huge red pimple on his cheek - close to his mouth. it looks exactly like a teenager face pimple with a white head. when i changed the water, the betta started bleeding from this pimple, for about a minute. i added bettafix to the water hoping he will get better. the betta eats and swims normally and is relatively active, except when it wants to rest, it seems to tilt towards the pimple.

the red pimple seems to concentrate blood on this side of the face, with a red vein strongly appearing from his mouth to his eye, and the area is slightly swollen.

i could not find anything online or in books concerning that issue and would appreciate your help,

thanks a lot

Answer
Dear AT,
If this is not white spot, or some sort of fungus, the only other thing I can think of is Columnaris. One of the symptoms is what looks like a white pimple around the head and mouth.
It is kind of difficult to treat, but you can start off by keeping the temp a bit lower than normal - no higher than 75 degrees, because in warmer water this bacteria will thrive. You'll want to start treatment right away.
Columnaris is a gram-negative rod bacterium, and you can treat it with an antibiotic that is effective against gram-negative bacteria or a broad-spectrum antibiotic. Kanacyn, Spectrogram, and Tetracycline  are all good choices. I have also heard of people getting good results with medicated foods containing oxytetracycline, but if your fish is having problems with its mouth due to the infection, this may not be an option.
To prevent this from happening again in the future, you must keep your fish's water quality optimal. I have heard from a lot of people that they heard Betta's like dirty water. This is a myth. Bettas do live in very small bodies of water in nature, yes. But they need good water quality just like any other fish.
You'll want to change out the water at least once a week, always make sure to add water conditioner and you might also consider starting to use aquarium salt since it helps prevent disease. Keep the temp between 75-85 (when he doesn't have Columnaris disease) and consider doing weekly water testing for ammonia, nitrates, and pH levels.
Best of wishes.