Hi
Yes, that size tank needs a water change done at least once a week, of only about 30-40%.

You don't want to feed bloodworms that frequently. Feed them only once, maybe twice a week because that's a lot of iron and not much else nutritionally. However, since I assume those are freezedried, you'll want to stop feeding them entirely. He looks like his stomach is bloated, and freezedried bloodworms are a major contributor to betta having that issue.

Also, he needs better food in general. Fluval Bug Bites and Devour Bug Formula, and any other brand that doesn't have a lot of ingredients and does have insect larvae as the first ingredient, are much better and species-appropriate.

Please stop the med. All of the 'fix medications and any others that have various tree oil ingredients in them can be harmful to betta's labyrinth organ.

Do much more frequent water changes, at least twice a week maybe three times, of only 30-40% for a while and add Vita Chem during the water changes.

It would be easier if you were to utilize this form even though you got some information posted;

Betta Fish Diseases and Emergencies

Betta fish can and do get sick. Discuss betta diseases and their cures, including medicines such as Melafix, Pimafix, BettaMax, etc., here. Get help for your sick betta.

www.bettafish.com

That said, I really think you need this information;

https://www.bettafish.com/threads/cycling-the-two-sentence-tutorial.507585/

This one has an embedded link that talks about 100% water changes, but doing that large an amount is no longer recommended due to stress to the fish and the risk of damaging the beneficial bacteria;
https://www.bettafish.com/threads/betta-basics-introduction-to-bettafish-care.232570/

Good brands of pellets are Fluval Bug Bites, Devour Bug Formula and New Life Spectrum. I like to rotate two or three brands, and members typically feed 4-5 pellets/crumbles twice daily.

Tank lights are extremely intense and bright and cause stress for fish. A couple of good live plant options are pothos and peace lily because not only do they not need any extra lighting at all, they don't require extra fertilizer. Faux silk plants are also good to help fill in the water column (bottom, middle and top) so that your fish doesn't feel exposed.

 

Thanks so much for your time a response! I’ve read the links and learned a lot. I‘ve included the form below You linked.

I can tell from this morning the growth had grown further on his fins. Any additional insight, other than to change water more, stop the API Primafix, get the better food you named? I almost never turn the light on. Sometimes just for five mins thinking he can see his food better.

Housing:
How many gallons is your tank? 4 gal
Does it have a filter? Yes
Does it have a heater? Yes
What temperature is your tank?
Does your tank have an air stone or other type of aeration? No air stone that I’m aware of after looking it up. It’s a biorb tank and has bubbles coming up the center tube.
Does your Betta have tank mates? What kind? No other mates.

Food:
What food brand do you use? Omega one betta flakes, and omega one frozen bloodworms
Do you feed flakes or pellets? Flakes
Freeze-dried?
How often do you feed your Betta? How much? Flakes once in the morning, bloodworms in the afternoon and sometimes flakes at night too.

Maintenance:
Before your Betta became ill how often did you perform a water change? Each month
What percentage of water did you change? 100%
What is the source of your water? Distilled water from jugs purchased at grocery store
Do you vacuum the substrate or just dip out water? we set aside some rocks and then rinse the rest of the rocks and aquarium pieces
What additives do you use other than conditioner? What brand of conditioner? We don’t use any conditioners

Water Parameters:
What are your water parameters? Please give exact numbers. If tested by pet store please get exact numbers. "Fine" or "Safe" won't help us help you. Important: Test your water before the regular water change; not after one. I’ve never tested the water. This is the first I’m hearing about doing it.

Ammonia:
Nitrite:
Nitrate:
pH:
Hardness (GH):
Alkalinity (KH):

Symptoms and Treatment:
When did you first notice the symptoms? A few days ago, maybe four
How has your Betta’s appearance changed? This growth appears to be growing quickly. It was one small spot on one lower fin and now it’s in two locations and covering 1/5-1/4 of fins
How has your Betta’s behavior changed? as of yesterday he’s been hanging at the top of the tank swimming occasionally but struggling while swimming
Is your Betta still eating? yes but small amounts
Have you started treating your Betta? If so, how? We were advised to use 2.5 ml of API Primafix dropped in the water daily.
Does your Betta have any history of being ill? At one point he had fin wilt but then he got healthy and fins grew back where they had shortened. Also he did have a large eye ball at one point and that also appeared to heal with nonintervention.
How long have you owned your Betta? 9 months
Was he or she ill or suffering some sort of damage when purchased? No, just seemingly depressed in his tiny cup.

Thanks again for any and all insight.

 

Water is 77 degrees.