Hair transplant and severe scratching, could small pimples be grafts I lost? (Photo)

It’s not uncommon to experience some itching after a hair transplant as the scalp heals, but I understand your concern about whether scratching or the appearance of small pimples could mean graft loss. At one month post-transplant, the grafts should have already become securely anchored in the scalp, so it's unlikely that scratching at that point would dislodge them permanently.
The small pimples you’re describing are more likely part of a condition called folliculitis, which is a mild inflammation of the hair follicles that can happen after a transplant. These are usually temporary and should clear up on their own or with proper aftercare. Folliculitis can sometimes cause some bleeding, but this doesn’t necessarily mean the grafts are lost.
However, scratching can still irritate the scalp and prolong healing, especially if it leads to bleeding or infection. It’s best to avoid scratching as much as possible. If the itching or pimples persist, it might help to use a mild topical treatment or consult your surgeon about options to manage the symptoms.
At this stage, your grafts should be well on their way to growing in, and it’s unlikely that scratching after one month would cause significant graft loss, but continuing to protect the scalp will ensure the best possible result.