IMO - the tail damage looks better, but the spots seem more numerous. I think it is ich. I think if you are going to try management, you’ll need to start right away. Try siphoning off the gravel tonight. If you are going to try peroxide, start now, plus use UV.Here are a few that kind of show his head spots
I can see 8 spots on the anal fin alone. kind of arbitrary, but fish with more than 30 spots total often don’t respond well to ich management.
Jay