The reader is concerned about the thickening in her palm as her late mother had a similar trouble that affected both her ring and little fingers. Eventually the fingers were drawn down on to the palm so that she could not straighten them, remove her rings or even cut her nails without difficulty. The reader wonders if this is the same trouble that Baroness Thatcher suffered. If it was, is there now any remedy?

The reader’s description of her mother’s troubles accurately encapsulates the signs of a condition known as Dupuytren’s contracture — this is where the fibrous tissue beneath the skin of the palm and the fingers proliferates. As it does so the fingers are drawn downwards until they may eventually almost touch the palm. The deformity prevents the increasingly claw-like fingers from straightening and eventually much of the use of the affected hand is lost.

As well as the finger deformity, the skin of the palm is puckered and the subcutaneous tissue in the palm becomes nodular, tough and fibrous. Lady Thatcher had this problem but surgery produced a good result. The secret is to have an operation before the range of movement is seriously restricted and joints have become fixed.

Dupuytren’s contracture does indeed run in families as the tendency to develop the condition is inherited through a dominant gene. It is more common in men than women, its incidence increases with age and there is a link to smoking. There is a higher incidence of people with the condition of Anglo-Saxon descent than there is in other races. Dupuytren’s contracture is associated with many medical conditions and occupations, any one of which might trigger its development in a genetically susceptible person.

It was previously thought to be an effect of holding vibrating machinery such as pneumatic drills. There was also a supposed link with sea captains and this was assumed to be the result of the skipper holding on to the bridge of a vibrating ship while he scanned the horizon in rough seas.

Pneumatic drill operators do have an increased incidence of Dupuytren’s contracture, but the current belief is that any association with sea captains is more likely to be the result of a taste for pink gins or rum than from hanging on to the bridge rail. People with diabetes, or with a family history of it, or a raised serum cholesterol level, are also more likely to suffer Dupuytren’s. Other conditions associated with it include alcoholic cirrhosis, epilepsy and TB. The same type of thickening that occurs in the palm of the hand in Dupuytren’s can also affect the sole of the foot, when it is known as Ledderhose’s disease, or in the penis, when it is referred to as Peyronie’s disease and gives the organ a curved appearance.

Raynaud’s disease is not associated with colour changes in the hand. This problem is usually related to spasm in the arteries of the toes and fingers and unlike Dupuytren’s it affects women more often than men. Your description isn’t typical of Raynaud’s phenomenon as the initial pallor of the fingers in this condition is followed first by a blue tinge to the fingers and then a bright red colour.

A 43-year-old teacher from Buckinghamshire, who is married with three young children, is worried about a receding hairline. His wife complains that when she married him he looked like Michael Caine but now he more closely resembles Steven Spielberg. What can he do?

There are two preparations that help male- pattern baldness. The regular application, twice daily, of a 5 per cent solution of Regaine (minoxidil) reduces hair loss in a reasonable proportion of men. The secret is to begin treatment early, and not to wait until the scalp is as bare as a concrete path. It may take up to four or five months for the benefit to show. Regaine shouldn’t be applied to other parts of the body, and the dose shouldn’t exceed 2ml daily.

Any man who becomes abnormally and seriously depressed as the result of male-pattern baldness is likely to be suffering from some degree of dysmorphophobia, a pathological and irrational dislike of a specific feature of his appearance. Dysmorphophobia is not usually a manifestation of heightened sexual activity, but there is considerable anecdotal and scientific evidence that premature bald men have higher levels of testosterone and are therefore more libidinous than their contemporaries.

Finasteride, the other medical treatment for male-pattern baldness, is a drug that is usually used to control benign enlargement of the prostate. It may cause some loss of potency in a very small percentage of men. When finasteride is taken to treat hair loss it is marketed as Propecia; the higher dose medication used to treat benign prostatic enlargement is known as Proscar.

Men taking finasteride, whether to treat a receding hair line or an enlarged prostate, should remember that it reduces the Prostate Specific Antigen (PSA) level and may therefore give a misleading result when routine checks are made to exclude cancer of the prostate.

Finally, our patient may prefer to have a hair transplant. The problem with hair transplants has been tufting. Even the most careful transplants tended to grow like marram grass on the shore, rather than a clipped lawn. A new system, follicular unit extraction, has been introduced in France. It claims to be able to remove one to three hairs at a time, to leave no scars, to be fast and not to plant any tufts.

E-mail Dr Stuttaford your questions on hair loss www.timesonline.co.uk/talkingpoint

Ask Dr Stuttaford: send other questions to drstuttaford@thetimes.co.uk or to times2, The Times, 1 Pennington Street, London E98 1TT. Include the following: the symptoms (and how long they have been present), age, sex and marital status. Dr Stuttaford’s replies cannot apply to individual cases but should be taken in a general context.