Nail changes during pregnancy

By trimester

Weeks 1–13

1st trimester

Nail changes are not shown to be a first-trimester-specific pattern in the research, so do not expect early, dramatic shifts. If you notice ridges, pitting, or a shape change this early, it is still worth mentioning at a prenatal visit rather than waiting.

Weeks 14–27

2nd trimester

If ingrown nails or white spotting are going to show up, this is a common window as swelling and circulation changes become more noticeable. Properly fitted shoes and nails trimmed straight across help with the ingrown-nail pattern specifically.

Weeks 28–birth

3rd trimester

Swelling in the feet tends to peak later in pregnancy, which can make ingrown toenails more likely if shoes no longer fit the same way. Continue routine nail care, and count any sign of infection around a nail as a reason to contact your provider rather than waiting until after delivery.

What does the evidence show for nail changes?

• A cross-sectional survey at an academic obstetrics center found nail changes reported by 34.2% of pregnant women versus 12.8% of nonpregnant women, a statistically significant difference, though most pregnant participants specifically reported no change in nail growth rate, thickness, or brittleness. 1
• The nail changes that were significantly more common in pregnant women were narrower than the general brittle-nails narrative suggests: ingrown nails (onychocryptosis) affected 12.3% of pregnant women versus 5.3% of nonpregnant women, and white spots on the nail (leukonychia) appeared in 13.7% of pregnant women versus 0% of nonpregnant women. 1
• A separate, larger study of 805 pregnant women found a lower overall rate, nail changes in about 8.06% of participants, illustrating that reported prevalence varies substantially between studies rather than pointing to one settled number. 2
• General nail-change guidance advises checking with a provider if nails develop pits, ridges, lines, or changes in shape, since these particular patterns can be related to iron deficiency, kidney disease, or nutritional deficiencies rather than pregnancy alone. 3
• Ingrown toenails, one of the changes found to be more common in pregnancy, are typically caused by poorly fitting shoes or nails trimmed too short or rounded rather than cut straight across, both fixable habits rather than an inevitable pregnancy symptom. 4
• Home care for a mild ingrown toenail is reasonable for most people, but anyone with diabetes, nerve damage, poor circulation, or signs of infection around the nail should contact a provider rather than handling it at home. 4

When should I call my provider about nail changes?

New pits, ridges, lines, or a change in nail shape are worth mentioning to your provider rather than assuming they are routine, since these particular patterns can also relate to iron deficiency, kidney disease, or a nutritional gap. An ingrown nail with fever, spreading redness, worsening swelling, or pus is a sign of infection that needs medical attention rather than home care, especially if you have diabetes, nerve damage, or poor circulation. Nail changes alongside other new symptoms, like unusual fatigue, hair loss, or skin changes, are also worth raising at your next visit rather than tracking on your own. None of these lists replace your own judgment: if this symptom worries you, that on its own is enough reason to check in with your healthcare provider.