Imipramine-Induced Alopecia Areata-Like Lesions

In 1987, a 36-year-old woman was treated for a 5 x 5 cm patch of hair loss on the posterior vertex of her scalp, which appeared clinically similar to alopecia areata. This hair loss coincided with her treatment with imipramine hydrochloride for depression and was accompanied by hair loss in her eyebrows. Histological examination of a scalp biopsy did not show inflammatory changes, and tests for autoimmune reactions were negative. Despite treatment with Diprolene ointment, topical minoxidil, and intralesional Kenalog injections, there was minimal response. Only after the cessation of imipramine did the eyebrow hair loss decrease. The association between imipramine and hair loss was acknowledged by the drug's manufacturer, although literature on the subject was not found by the treating physician.