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Today I noticed my betta's black face has two white spots on the top of the head. They are not raised or salt-like so I do not think they are ich. Does this look like he just scratched his head on something and lost some scales?

If so, I don't understand how. In the tank I have sand as substrate, smooth stones and marbles, a few silk plants, a filter, heater and a cave decoration that is incredibly smooth. I even sanded any slightly square edges to round them out. SO. FRUSTRATED.

Also, he is more frequently getting white stress stripes on his face at little things and during water changes? Anyone know how to minimize stress? Otherwise he is very active and seems healthy. I'm attaching some pics of his head.
 

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If the spots look like regular skin underneath hes likely banged his head on something, its amazing how bettas manage that. They can be a bit of a pest finding the one bit you never thought of and hoarding it as a scratching post for later.

As to keeping him calm, having a routine during water change works- always use the same cup to transfer him, possibly even feed him a treat while in it and keep yourself in view. I do this with my own boys and they have completely stopped jumping and freaking out during changes.
You can also add indiant almond leaf to his tank water which will turn it a nice tea color. bettas love brackish water and it keeps them calmer.
 
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