Imiquimod cream 5% is an immune modifier approved for the treatment of genital warts, actinic keratosis, and basal cell carcinoma. This case report presents an isolated case of telogen effluvium after 6 weeks of imiquimod treatment for an actinic keratosis on the scalp. Based on this case presentation, telogen effluvium is a potential rare side effect from imiquimod treatment.