Does your face turn red while or after you drink alcohol? Fortunately, you’re not the only one. It doesn’t happen to everyone, but for some of us, going out and having drinks results in a deeply flushed face.
But why does alcohol make your face red? The simple answer is because some of our bodies are not fully able to process the alcohol they consume. The flushed skin as you drink is your body’s way of letting you know that it’s not metabolizing alcohol the way it should be. Blood pressure skyrockets when alcohol is consumed and the liquid is broken down into a compound called acetaldehyde. When your body cannot metabolize the compound during this process, the blood capillaries in your face dilate, resulting in a visibly blotchy face. Other symptoms may include rapid heartbeat, nausea, and headache. In other words, alcohol flush reaction or “alcohol flush syndrome” usually occurs in people who are unable to break down acetaldehyde, the first metabolite of alcohol.
The condition is more common in women and East Asians – explaining why it is commonly called “Asian Flush” or “Asian Glow”. It is attributed to a genetic change that makes a less functional version of the enzyme responsible for breaking down acetaldehyde. As a result, acetaldehyde builds up in the body.
Scientists estimate that there are at least 540 million people worldwide that experience this issue – that’s about 8% of the population. 1 People of Japanese, Chinese, and Korean descent are more likely to have an alcohol flush reaction. At least 36% and perhaps up to 70% of East Asians experience facial flushing as a response to drinking alcohol. 2 Some research has also shown people of Jewish origin might also be more likely to experience the “Asian Glow”. It’s not known why certain populations are more likely to have this problem, but it’s genetic and can be passed on by one or both parents.
Alcohol metabolism in people of Asian descent
Alcohol metabolism is dependent on two enzymes: alcohol dehydrogenase (ADH) that converts alcohol to acetaldehyde, and acetaldehyde dehydrogenase (ALDH) that further converts acetaldehyde to harmless products (like acetate).
About 80% of Asians have a hyper-functional alcohol dehydrogenase.3 That means Asians metabolize alcohol to acetaldehyde up to 100 times faster than others, but never really experience the buzz that normally comes with booze. Additionally, 40% have some sort of malfunction of acetaldehyde dehydrogenase (ALDH) that metabolizes further down the acetaldehyde. This is essentially a “double whammy” – they metabolize alcohol intake far too quickly into a toxic stage where it can’t easily get out.
In practice, that glass of wine is converted to acetaldehyde too fast, and it just gets stuck inside of sufferers — then uncomfortable side effects ensue. Basically, their bodies aren’t fully equipped to break down alcohol in a safe and enjoyable way. It’s safe to call this an alcohol allergy.
The syndrome can increase the risk of certain diseases and cancers. The build-up of acetaldehyde is what causes blood vessels to dilate and the face to turn red. But the problem goes beyond aesthetics: Acetaldehyde is more toxic than alcohol and a known cancer-causing agent.
Acetaldehyde can trigger inflammation in the upper gastrointestinal tract, cause DNA damage, and increase one’s risk for gastrointestinal diseases, namely esophageal and stomach cancers as well as peptic ulcers.4 If you have Asian flush syndrome and drink two beers a day, your risk of esophageal cancer can be up to 10 times higher.5
The Good: Lower rates of alcoholism among Asian Americans
From a purely statistical perspective, Asian Americans seemed to have largely avoided the substance abuse problems affecting other ethnic groups in the United States. The National Institute on Alcohol Abuse and Alcoholism found that Asian Americans drink less than white Americans and African Americans: 38% compared to 59.8% and 43.8%, respectively. 6 And this is likely due to alcohol flush reaction as many east Asians avoid drinking because of its negative effects.
5 tips on how to better cope with Asian flush syndrome.
- Don’t drink, or drink moderately – If you must drink, drink moderately. Men should limit themselves to two standard alcoholic drinks per day and women should stick to a maximum of one alcoholic drink per day.
- Choose drinks with less alcohol content – Read the bottle labels. Choose red or white wines with 12.5% or less alcohol per volume (APV). Beers, wine coolers, table wine and sparkling wine have lower APV than spirits.
- Eat well before you drink – A full stomach protects the stomach lining against excessive irritation due to alcohol consumption. Snacking on fatty and carbohydrate-rich foods such as seeds, nuts, cheese, pizza, pasta and bread can also prevent the alcohol from entering the small intestines too quickly and thus can slow down the rate of alcohol absorption.
- Drink plenty of water – Because alcohol is a diuretic, it can increase your thirst. Quench your thirst with water or non-alcoholic drinks instead of with more alcohol.
- Take supplements to accelerate alcohol metabolism – When we consume a large amount of alcohol in a short period of time, toxins will accumulate in the blood and body tissues until it can be metabolized. This toxin accumulation in our bodies is what causes a headache, nausea, and fatigue associated with drinking.
- The Alcohol Flushing Response: An Unrecognized Risk Factor for Esophageal Cancer from Alcohol Consumption
- Treatment of Asian Flushing Syndrome with Topical Alpha Agonists
- ALDH2, ADH1B, and ADH1C Genotypes in Asians: A Literature Review
- ALDH2 polymorphism and alcohol-related cancers in Asians: a public health perspective
- Alcohol Flush Signals Increased Cancer Risk among East Asians
- Ethnicity and Health Disparities in alcohol Research