Nail alterations during pregnancy: a clinical study

Abstract

During pregnancy, cutaneous and appendageal alterations manifest and may cause concern in the subject. The nails may be affected by pregnancy. This study investigated the frequency and nature of nail changes occurring during pregnancy in 312 healthy, 18-40-year-old pregnant women in gestation weeks 16-40. After a routine obstetric examination at the obstetrics and gynecology clinic at the study institution, all subjects submitted to an examination of all fingernails and toenails. Only nail alterations that had developed during pregnancy were recorded. Any nail changes that had occurred before the start of gestation were not considered. Data were presented as percentages. The Shapiro-Wilk and chi-squared tests were used to make categorical comparisons. A P-value of < 0.05 was considered to indicate statistical significance. No nail pathologies were detected in 116 (37.2%) of the 312 subjects. The most commonly found nail change was leukonychia (24.4%). Ingrown toenail (9.0%) and onychoschizia (9.0%) represented the second most common nail changes. Rapid nail growth and subungual hyperkeratosis were observed in 6.7% and 4.2%, respectively, of subjects. When the alterations were evaluated according to gestational age, the most common nail pathology was leukonychia at both 14-28 weeks (16.3%) and 29-42 weeks (27.4%) of pregnancy. Leukonychia, onychoschizia, onycholysis, and brittle nail pathologies were frequently observed at 29-42 weeks of pregnancy (P = 0.047). A large proportion of nail changes that occur during pregnancy are benign and do not require treatment. However, these changes may cause significant cosmetic stress in women.

Physiologic changes of pregnancy: A review of the literature

“…Studies report that nail alterations occur in 2% to 40% of gravid women ( Erpolat et al, 2016 , Rathore et al, 2011 ). The most commonly occurring changes are leukonychia, onychoschizia, and ingrown toenails but increased nail growth, onycholysis, melanonychia, and subungual keratosis are also described ( Erpolat et al, 2016 , Ponnapula and Boberg, 2010 , Soutou and Aractingi, 2015 , Turcic et al, 2009 , Tyler, 2015 , Van Onselen, 2012 ).…”

“…Studies report that nail alterations occur in 2% to 40% of gravid women ( Erpolat et al, 2016 , Rathore et al, 2011 ). The most commonly occurring changes are leukonychia, onychoschizia, and ingrown toenails but increased nail growth, onycholysis, melanonychia, and subungual keratosis are also described ( Erpolat et al, 2016 , Ponnapula and Boberg, 2010 , Soutou and Aractingi, 2015 , Turcic et al, 2009 , Tyler, 2015 , Van Onselen, 2012 ). Benign, uniform, symmetrical hyperpigmentation of the multiple nails is reported during pregnancy with fading that occurs postpartum ( Bieber et al, 2017 ); however, irregular pigmentation with cuticle involvement should be referred to a dermatologist for evaluation of possible melanoma.…”

Morphology, growth rate, and thickness of the nail plate during the pregnancy

“…Studies conducted almost 60 years ago reported that pregnancy increased the growth rate of nails . Several studies conducted since then have also reported that pregnancy accelerates nail growth, with references to these earlier studies . In addition, it has also been reported that leukonychia, subungual hyperkeratosis, distal onycholysis, transverse grooves, softening, and brittleness in nails might be encountered during pregnancy …”

“…6,7 Several studies conducted since then have also reported that pregnancy accelerates nail growth, with references to these earlier studies. 8,9 In addition, it has also been reported that leukonychia, subungual hyperkeratosis, distal onycholysis, transverse grooves, softening, and brittleness in nails might be encountered during pregnancy. [9][10][11][12][13][14][15] Studies about the effect of pregnancy on the hair follicle, which is considered the analog of the nail unit, showed an increase in hair diameter and in the number of hair follicles evident during the anagen phase.…”

Physiological changes of the skin during pregnancy

“…У некоторых женщин отмечаются продольные темные линии (меланонихия) [31] лечением кутикулы требует немедленного внимания дерматолога или онколога для исключения меланомы. При обследовании ногтей на руках и ногах у 312 женщин наиболее часто отмечалась лейконихия (24,4%), на втором месте были вросшие ногти на стопах и онихошизис (по 9,0%), ускорение роста ногтей замечено в 6,7%, подногтевой гиперкератоз в 4,2% случаев [36].…”