⚠️ Hair falling out off 4 year old ⚠️

This is my niece's head, her hair is falling out from these spots. What could this be or mean ? They itch her and they are sooo dry looking. She has about 3 spots like this. And when her hair is pulled on these areas it falls out easily. Any info is appreciated, thank you ! *

my sister has made a doc appointment but it's not till awhile and I thought about asking on here in the meantime*