Ich i think??

but the fish is scratching so much hes damaging himself is there something else that could cause this?

Don't know, but looking at the picture you posted, your Tang does NOT appear to have ich.

I have a Chocolate Tang that sometimes will scratch himself against some rock, coral or sand. Sometimes it leaves a mark on him. He is otherwise healthy and in great shape, so I don't sweat it.
 
Ich is far from a flu.

The flu virus does not leave the human body as a part of its lifecycle and then come back into the envirnoment in a much larger wave.

The natural pathogen-host relation of the flu virus depends on incidental contacts, life and death struggle between pathogen and host, and win or lose.

That of ich involves the pathogen naturally limiting itself by leaving the host and then coming back in a large wave, but nearly all die without finding a host. This is why the effect of confinement is far more fundamental for ich.

Ich infestation can be very small so that the human eye cannot detect by observing. Only after a while does it become the size of a period (.), so frequently it cannot be seen. Plus it can be in the gills and so cannot be seen.
 
Ich is far from a flu.....

Granted, ich is not the flu. My point is that most times an otherwise healthy fish will fight it off. Just like us, 99.99% of the time, we will fight it off on our own if we do nothing. Take a look at the pic I posted above. I had at least 5 other fish in the tank at the same time as that pic was taken. None of them came down with it and all are still alive today, over a year later.
 
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