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Hole in the Head?

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I think my cichlid might have Hole in the Head disease. He's developed some holes in his forehead right between his eyes that look just like his nostril holes, but they weren't there when I bought him. He's lived with me happily for 9 months now, and I'd like it if he would stay that way :) He's a young red devil cichlid, and he's a picky eater that will only eat Tetra cichlid sticks. He refuses Dainichi food or any vegetables. I'm nervous about feeding him live fish because I'm afraid of parasites, but if it will help him, I'll try it. As a textbook devil, he ripped out the plant I had in there and threw the shell decoration against the side of the tank repeatedly until I removed it. He's pretty content rearranging his gravel in a different way every night, but I worry that he gets bored. I clean the tank and do a 20%+ water change once a week, and do a deep cleaning of the filter and everything else in the tank about once a month to every 6 weeks. I keep a good eye on the pH level as well. Anything else I should be doing that I'm not that might help?

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