Reply to trichotillomania or something else?

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[quote=Anonymous]Hi everyone, My teenage son has ADHD and has been on a stimulant medication for many years, but over the summer had a medication change to another stimulant  since his long time med no longer seemed to be working effectively.

Over the past few months I’ve noticed he’s been pulling at his hair, and hes always responded that his scalp was bother him which we attributed to a dry scalp, hat wearing or hoodie wearing. Yesterday, I saw the top of his head clearly for the first time in a few weeks and now he has a noticeable bald spot. The skin looks normal, not red or irritated and there’s some hair there of varying lengths.

I’m wondering if this could be anxiety, a medication side effect, or possibly trichotillomania, which I only recently learned about. His baseline has always been a little nervous about new situations, but never to the point where he would not engage, etc.

For background, he’s been evaluated for autism three times over the years, most recently in 5th grade, now in 9th, and has never met criteria for an ASD diagnosis, though he does have some sensory needs. He’s always been fully mainstreamed, plays sports, does other activities, has friends, and says he likes high school, his classes, and his teams and says he feels fine emotionally, which makes this harder to understand.

Has anyone else seen hair pulling start around medication changes or big transitions like high school even when things seem fine on the surface? What ended up helping? I would also really appreciate recommendations for types of therapists or therapies that were helpful.

I was able to get an appointment with his doctor later today and will be bringing this up. Part of me is ready to just stop the medication, but I worry about how that could affect the rest of his life and functioning, so I’m trying to be thoughtful.

Thank you so much.[/quote]

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