Lisdexamfetamine-Associated Tonsure Trichotillomania

Lisdexamfetamine is a Food and Drug Administration–approved medicine for treatment of attention-deficit/hyperactivity disorder (ADHD) in children and adults. Central nervous system (CNS) stimulants including lisdexamfetamine are typically well tolerated, with the most common side effects being change in appetite, sleep, and mood. Dermatological side effects like rashes (<3%) are rare, and there are few reports of recurrent pulling of hair (trichotillomania) with CNS stimulants in children. Here we present an interesting case of tonsure trichotillomania (extreme form of hair loss characterized by complete balding except a strand of hair left on scalp) with lisdexamfetamine in a child with ADHD and comorbid anxiety disorder. Verbal consent from the parent and assent from the patient were obtained.