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The wife of Syrian dictator Bashar al-Assad has made her first public appearance since beginning treatment for breast cancer two months ago.

An image of Asma al-Assad wearing a scarf on her head and appearing emaciated has been widely on in regional media outlets and shared on social media.

The Syrian state news agency announced in August that Asma had begun the initial stage of treatment for a malignant tumour in her breast.

Bashar al-Assad was photographed talking to his wife at a military hospital in Damascus at the time.

The state-run agency has failed to report on the Asma’s condition since then.

Asma's marriage to Bashar was announced by state media around six months after he assumed the presidency in July 2000 following the death of his father Hafez.

The former investment banker styled herself as a progressive rights advocate and was seen as the modern side of the Assad dynasty.

She did not appear much in public in the first few years of the uprising, but over the past two years has been a lot more active.

In 2012 private emails revealed the 42-year-old who is a British citizen had spent £250,000 on 130 pieces of lavish furniture during the first year of the devastating Syrian war.

She had also bought a pair of shoes for £5,000 with crystal-encrusted heels, according to Wikileaks.

The mother-of-three has stood at her husband's side in his rare public appearances, posing for selfies with supporters in pictures posted to the presidency's Instagram account.