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deficiencies in zinc or vitamin D have been proposed as possible contributors, though the evidence is uncertain and routine testing for these is not generally recommended without a specific clinical indication [10] Tinea capitis (a fungal scalp infection), which is an important cause of patchy hair loss particularly in children Scarring (cicatricial) alopecias, which are less common but require prompt specialist assessment Significant psychological or physical stress, rapid weight loss, and major illness can also trigger telogen effluvium independently of any medication