A new image reveals the ageing hand on the Russian nuclear button.

Vladimir Putin, 73, is strongly suspected to secretly undergo regular plastic surgery on his face to hide the impact of ageing from his people.

But now his right hand is seen with visible bulging veins, prominent tendons, and thin, wrinkled skin.

Ukrainian sources conjecture that the Russian dictator may be suffering from pain.

Prominent interviewer and media personality Dmytro Gordon said: "Putin clenches his hands into something resembling fists.

"They look swollen and sore, with veins bulging prominently on one hand."

Politician and security expert Anton Gerashchenko said: "There's something wrong with Putin's hands.

"Apart from the fact that they're covered in blood up to the elbows [from his killing in the war], his veins are bulging too."

Nexta channel commented: "Online users are puzzled by what happened to the Russian dictator's hands. They look extremely painful."

Other source say that Putin merely exhibits the normal signs of male ageing which he seeks - through cosmetic surgery - to hide from Russians after more than a quarter of a century in power.

The picture comes two months after Putin and Chinese dictator Xi Jinping, 72, enthusiastically discussed biological innovations which might allow them to live to 150.

Putin told his fellow despot: "Human organs can be continuously transplanted. The longer you live, the younger you become."

In an overheard conversation in China, Xi told Putin: "People used to rarely live to 70, but now at 70 you are still a child."

Putin showed his bulging veins while talking to 22 year old Yekaterina Leshchinskaya, 22, who heads a group the loyalist Healthy Fatherland group which calls for a ban on vapes in Russia.

"The president supported our initiative," she said.

Putin - in power as Russian president or premier since 1999 - regularly issues threats through his proxies to launch nuclear strikes on the West or Ukraine.

He is often pictured with the Russian nuclear briefcase - carried by a flunky - to emphasise his power in being able to unleash Armageddon on the world, highlighting that it is his hand on the button.

Putin health fears soar as viewers spot grim mark on dictator's hand