The Gist of It
- Flushing is caused by an enzyme disorder in your liver which cannot break down acetaldehyde.
- Alcohol flush syndrome has been associated with higher risk of esophageal cancer and hypertension.
- There’s no cure to alcohol flush syndrome, except for avoiding alcohol.
Hello there drinker! What’s your favourite drink? Oh, beer you say? Do you turn red really quickly after consuming half a can of your favourite beer? If your answer is yes, ever stop to wonder what that means? We asked a few people at a bar one night, after feasting our eyes on blotchy redness all over. “My circulation is in tip top condition, that’s why!” one guy exclaimed. “I’m allergic to alcohol, but I like drinking sometimes,” said another girl. “It’s just our Chinese genes!” said a group of friends. A study showed about a third of Japanese, Chinese, and Koreans respond to alcohol by turning red. It’s such a common sight to see a sea of red faces all over bars and clubs in Asia that we don’t even think to question it. Those of us blessed enough to not turn into a tomato after a drink or two, laugh at our friends who do. And those of us who turn red? We shrug it off as a harmless genetic malfunction and continue with our drinking habits. But is it all just fun and games?
Why Does The Dreaded Alcohol Flush Happen?
Some people believe this is due to Asians being unable to metabolise alcohol. While that might sound very scientifically accurate, it’s not the case. And no, it’s also not you having exceptionally good blood circulation. Alcohol is metabolised in your liver, where it is oxidised first to acetaldehyde, and then converted to acetate by an enzyme known as aldehyde dehydrogenase (ALDH2).
Those who turn red after a bit of alcohol have a genetic change in their ALDH2. The gene variant causes the body to metabolise alcohol more quickly, but become less efficient in breaking down acetaldehyde. The buildup of acetaldehyde is what causes your blood vessels to dilate and your skin to turn red[1]. This condition is known as alcohol flush reaction, but since it happens mostly to Asians, it’s been nicknamed the Asian flush or the Asian glow [2]. Lovely name, indeed.
What Other Symptoms Will I Get Besides the Redness?
Well, you wouldn’t be a stranger to headaches and nausea. Some people also report itchiness on the skin.
The Asian Flush is Associated with Higher Risk of Hypertension and Cancer
Some people dislike drinking because of the redness and itchiness they get on their skin, while some others ignore the cosmetic side effects to have a good night out. But recent studies have revealed evidence that ALDH2-deficient individuals are at much higher risk of developing esophageal cancer from consuming alcohol, than those with a fully active ALDH2 [3]. Esophageal cancer also happens to be one of the deadliest cancers in the world, with pretty low survival rates. [4] Acetaldehyde is a metabolite of alcohol, but is also an animal carcinogen and mutagen with recognised cancer-promoting properties [5]. When the tissues of your upper aerodigestive tract is repeatedly exposed to acetaldehyde, the probability of DNA damage and mutation could also increase [6]. In a paper published in 2013, researchers studied 1,763 men, including non-drinkers, flushers, and non-flushers. They found that flushers who drank the same amount of alcohol (more than 4 drinks, less than 8) as non-flushers were at higher odds of getting hypertension. The risk of alcohol-related hypertension was also much higher among flushers who consumes more than 4 drinks a week [7].
Treatment Options for Alcohol Flush
Unfortunately since it’s a genetic problem, there’s currently no cure for the alcohol flush, except to avoid alcohol. Although the use of antihistamines can prevent the redness, it doesn’t change the fact that your body cannot break down acetaldehyde. This means you’re still putting yourself at risk for developing esophageal cancer and hypertension if you continue drinking.
But It’s Not All Bad
Since the enzyme disorder causes people to go red after just a tiny hint of alcohol, there are plenty who shy away from drinking. Nobody likes hearing embarrassing stuff like “Hey you look like a tomato” or “Man, you’re red as a butt on fire” all the time.
Also, since flushers experience some not-so-great reactions when downing alcohol (like itchy skin, headaches, etc), they can’t really drink too much. Studies show how this can play a role in preventing alcoholism [8]. So effective is the flush at preventing you from becoming an alcoholic that pharmaceutical companies are using the science behind it to develop drugs to help recovering alcoholics. Antabuse uses Disulfiram to block the processing of alcohol in the body [9], which causes the same symptoms as flushing.
What To Do Now
If you get red after a drink or two, you should think about drinking less, a lot less. While you may call us a party pooper, it’s good to understand that you’re putting yourself at a higher risk of developing both cancer and hypertension. Also, to those who do not turn red after drinking, this is not a license to go crazy. Moderation still reigns supreme, and too much alcohol can also do nasty things to your body. General agreement of “moderate drinking” is about one to two drinks a day for men, and one drink a day for women.
See also:
- Why Alcohol and Caffeine Don’t Mix
- 6 Hangover Cures that Actually Work
- How Many Calories are in Your Beer?
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Are you an Asian Flush victim? Share your experience with us in the comments below or on our Facebook page!
I used to turn really red and hot when I first started drinking alcohol. I once got extremely sick after raiding a liquor cabinet and taking a few drinks, (I’d gotten truly drunk once or twice before this and knew my limit, this was different). I got hives and rashes where my clothes were touching my skin, like around my neck and my waist. This turned me off alcohol, especially since my mother warned me that she’s allergic and doesn’t drink at all. However, a year or two later I tried drinking in moderation again, and sometimes would turn so red and hot it was uncomfortable and distracting. But I realized that the redness goes away after an hour or two, and I never got another episode with hives and rashes. Now that I’ve been drinking moderately for 5 years or so, I noticed I hardly get red anymore. My face doesn’t get hot, sometimes I’ll turn a little pink after my first beer but I’m never so red that someone makes a comment.
Some people swear by pepcid ac, it’s worked a few times for me but like the article says, it doesn’t fix the underlying problem that’s causing the redness. Also I felt like certain alcohol/timing of how much I ate affected the redness but I never found anything conclusive. Also, I read about the cancer risks before and realized that the chances might be higher, but are still slim so you shouldn’t worry too much about it. Anything you do in life increases your chance of getting cancer, just be smart and drink in moderation. Also try drinking 1 or 2 drinks and seeing if the redness goes away after an hour before drinking more.
Hi James!
Thanks for dropping by! Yes, drinking in moderation is key.
Thanks for sharing your personal experience with us, appreciate it a lot! 🙂
This is stupid.. your story will only make people with asian blush more prone to cancer. Some studies found people lacking aldehyde dehydrogenase also don’t turn red once they become dependent on drinking. This is not a good thing at all.
I don’t think you know what prone means.
This is stupid you say, yet you turn around and tell everyone that “your story will only make people with asian blush more prone to cancer”. How does this even make since? A person’s story doesnt do anything beside speak the mind of someones own opinion… your argument is invalid
I am one of the victims of alcohol flush. It happens everytime with beer. My face will be red by drinking just half a can or pint. But I realise that hard liquor(e.g. Martell) doesn’t have the same effect. My face dont really turn red; maybe pink at most.
Sometimes the redness actually goes off after drinking more beer. And the face will become pale rather than red.
Hmmm. I hope my experience can help those doing research on this. Haha.
Anyway, everyone should know their own limit. Don’t drink till your mind goes off.. Drink responsibly.
Cheers!
Does it also applies for people who eat a lot? My friend noticed that I have rosy cheeks after having lunch. This is really scary. I havnt had any alcohol for the last 4 months..
That is called rosacea. Its usually foods like tomatoes and peppers that cause it. I don’t believe there are any serious downfalls of having Rosacea, just that you cheeks get bright red.
Now I know why they call me “Hellboy” everytime I drink. 🙂
that is exactly what they call me just right after drinking a drop of wine or beer. tsk
I seldom drink alcohols because i’m allergic to it, especially to beers and gin. Just only a half glass of beer makes me red and itch. But i don’t know why is vodka (only) suitable for me? If i drink vodka i don’t get red easily and i don’t itch as well, i just drink vodka in moderation. Why is that?
Hi Carlisle!
According to the doctors, sometimes you might be allergic to certain type of alcohols as different kinds of alcohol are brewed differently. If vodka doesn’t get you red or itch, stick to that, you should be fine. Remember to continue the good practice of drinking in moderation. Moderation is about 1 standard drink for girls, and 1 – 2 standard drinks for guys (per day). 🙂 Hope this helps.
i’m a regular drinker, i almost drink every week . in my case, whenever a drink i turn so red and I’m palpitating? what does it mean? is it dangerous?
Hi petersergsmendiolasergs,
Sounds like your body (or specifically, liver) cannot break down acetaldehyde well too. If everytime after one drink you’ll flush and your heart rate goes up, you really might want to consider drinking a lot less. Not too sure whether it’s downright dangerous for you now yet or not, but it might put you at a higher risk for other health problems. We encourage you to consult your doctor or pharmacist so they can also check on other contributing factors 🙂
I got the same issue. After i drink even a small amount of alcohol, i turned red not just my face but also my whole body turned red! It also gave me a feeling of itchiness and a hot feeling. Jeeeezzzz
Great article. I knew I lacked the enzyme and hated the taste of alcohol. I tried so many times to get use to it and finally gave up and drank coke instead. Dunno which one is worse.
Thanks for the information and your article may be saving lives when they realize the hype may be killing them.
Looking forward to reading more useful articles.
Thanks Yoshi for your feedback! Glad you find them useful!
This is exactly what is happening to me every time I drink beer or any alcoholic drink. Now I know why it is happening to me. Thank you so much for this article this really helps me a lot.
I’m looking forward to reading more useful and helpful articles from you.
Thank you and more power 🙂
Thanks RegMagboo!
Glad you find it helpful! 🙂
Hi! Why is it that moderate drinking mean 2 drinks a day for men and 1 drink a day for women? What’s the reason behind the differentiation?
Hi Pia!
This limit is generally agreed by the experts in the industry. Here’s where we got the number from: http://www.cdc.gov/alcohol/faqs.htm#moderateDrinking Hope that answers your question!
It’s because women’s body content contains a higher proportion of fat, thus absorbing less alcohol. In addition, women have less dehydrogenase (a stomach enzyme) than men to metabolise alcohol before it enters the bloodstream. Both contribute to higher concentration of alcohol in women’s blood than men for the same amount of drink. Higher concentration = more effects = you should drink less.
I’m always super interested in articles about this topic! I’m half Japanese, half Caucasian, and I get the alcohol flush reaction in an extreme way — my skin gets really red, eyelids get puffy, my heart starts racing, I feel extremely hot, my breathing becomes shallow, and I become faint… I’ve even actually fainted a few times (the only times in my life!). I’ve never had more than half a glass of champagne and can feel the symptoms from even the tiniest sip of alcohol. Beer, wine, champagne and even kombucha seem to provoke the worst reaction.
It’s the weirdest affliction, but after “trying” to drink here and there all through my early 20’s (not like it was ever enjoyable), I just don’t even try anymore. Luckily I don’t think it has impacted my life in any negative way and when people ask me how I cope with life (especially fellow students when I was in law school), I just tell them that I get to spend the money I save not buying drinks on shoes instead.
I’m adopted, so I don’t know who I get the deficient genes from, but my adopted dad and sister are also Japanese and can REALLY drink. It’s so interesting… thanks for the article and the explanation! Proof I’m not just a lightweight!
Hello there appleandarrow,
We’re so glad our article helped explain your condition! You’re definitely not a lightweight!!! We’re happy that you listened to your body and stopped drinking, that’s actually a really smart move! So many people never learned to listen to their bodies! 🙂
Hey appleandarrow, I feel you with the champagne and wine, it seems like I only have to take a few sips to get bright red! But I love that you found a way to cope and found the positive side of all this.
Jolene, great article, I don’t think I’ve seen that many images that clearly describe our condition. Super helpful! I agree that moderation is the way to go. For curious minds, here’s my site that puts a funny and positive side on drinking with moderation to avoid asian flush, http://www.asianflushninja.com, enjoy and thanks.
Two weeks ago, me and my boyfriend went to drink, what happened was I drank a strong russian vodka ( I believe) and ate a spicy cheetos, right after few minutes of consuming it, I turned red and started to palpitate and worse was I had a hard time breathing and my whole chest was aching.. i vomited, drank lots of cold water and put a cold bottle of water on my chest. I was finally relieved. I also turned red when eating sour things (e.g.) unripened mango. I wonder if I need to continue consuming all these stuffs and if I continue having it, it’ll affect my health or it is been affecting my health without me knowing?
this is common among asians… not really an issue to health if u dun drink excessively. even if u do drink, stop in between sips and have some snacks to go with it. point is, drink in moderation. drinking some alcohol is beneficial to health but drinking excessively ruins it.
i am caucasian, and started to develop these symptoms in my mid 30’s. prior to that, no changes in skin color at all after drinking. now, though (i’m 45), even 1 sip of any beverage containing alcohol will leave me with blotchy red skin from the neck up combined with small hives that burn and itch. i can sense the red areas without even looking into a mirror.
as a result, i’ve stayed away from alcohol completely for the past 12 years or so.
What is the risk or getting esophageal cancer in the general population? What is much higher risk of developing esophageal cancer? If the odds of getting esophageal cancer is 1 in 10,000,000 and drinking triples it to 3 in 10,000,000, I would not be worried about the increased risk. I feel with out providing these numbers the story is incomplete and I can not make a well informed decision. I read one of the studies posted and they also did not provide these numbers.
Hi Jeffrey!
You’re right! These numbers do help to provide some perspective. We did a bit of digging and found that stats in the States showed about 4.4 per 100,000 men/women getting the cancer per year (Source: http://seer.cancer.gov/statfacts/html/esoph.html). And while that is not all that high, if you flush, consuming alcohol still increases your risk. Also, there is ample evidence showing over-consumption of alcohol isn’t great for anyone – regardless of whether you are a flusher. Moderate consumption of alcohol, on the other hand, has been linked to some good health benefits. So the decision is yours. At HealthWorks, we always emphasize on balance and moderation. We want our articles to spark discussion and conversation, to get people talking about health, do their own research and come to their own conclusions. And it seems we have done that with this 🙂 Thanks for writing in and giving us another perspective!
I can relate much! Hahaha. Thanks for the health alert! Funny when I’m drinking with friends and started to turn Red, I look at my tummy to see if its Red too, this is how I check my Redness Indicator.
Excellent article! 🙂 I liked reading the description of you as well, you’re witty and there’s a nice flow to your article, it’s fluid.
Thanks for the kind words Mae 🙂 This made my day!
I don’t turn red when i’m drinking but the effects show up when I wake up the next day. My whole neck will have rashes which is really itchy and feels very hot so I just take an antihistamine and it will eventually go away at the end of the day. Is this the same as alcohol flush? Great article btw 🙂
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wow this explains a lot! Great article Jolene, I don’t have those flushes but I do wonder why most of my friends turn red whenever we drink. Looking forward for more write ups 😀
Thank you Jolene. This article clarified my understanding of alcohol dehydrogenease and aldehyde dehydrogenase
Hello, i just wanna ask is it true that Alcohol flush reaction are associated with hypertension? because i have a low blood pressure and i think i can drink quite a lot without getting dizzy or itchy or getting drunk even though if i drink just a little bit says a glass of beer will already make me red like a boiled crab or something..
Hi Shans!
One of our expert has shared his opinion.
Although there is study showing that flusher has higher risk of hypertension than non-flasher, the cause is unknown and the evidence is inconclusive. However there is a definite association between alcohol intake and blood pressure. The increase in blood pressure is approximately 1 mmHg for each 10 g alcohol consumed. Heavy drinking can lead to various physiological and psychological issues.
On the other hand, light to moderate intake of alcohol could provide some extend of protective health benefits. Yet, the magnitude of any protective effect appears to have been exaggerated due to other con-founders such as diet and lifestyle.
In conclusion, do not overdo it. If you drink, follow recommendation- one to two standard drinks a day in men (10–20 g alcohol) and up to one a day in women (10 g alcohol).
Further reading:-
Facial flushing is a sign of ‘alcohol intolerance’- http://www.nhs.uk/news/2013/11November/Pages/Facial-flushing-is-a-sign-of-alcohol-intolerance.aspx
Puddey IB, Beilin LJ. Alcohol is bad for blood pressure. Clin Exp Pharmacol Physiol. 2006 Sep;33(9):847-52.
Hope this helps!
Whenever I used to have a sip of alcohol my face got red..my heart beat goes faster n I feel my scalp got itchy ….what to do …? I read all the articles have I suffered from oesophagus cancer
Hi Pankaj!
The symptoms for oesophagus cancer are for example: throat pain, consistent coughing, or having difficulty swallowing. Are you having these symptoms?
It looks like you might have a higher allergy to alcohol, given that some part of your body will itch. If it happens only with just one sip of alcohol, would encourage you to stop drinking instead. Or, the next time when you drink,follow recommendation- one to two standard drinks a day in men (10–20 g alcohol) and up to one a day in women (10 g alcohol).
Further reading you can check:
Facial flushing is a sign of ‘alcohol intolerance’- http://www.nhs.uk/news/2013/11November/Pages/Facial-flushing-is-a-sign-of-alcohol-intolerance.aspx
Puddey IB, Beilin LJ. Alcohol is bad for blood pressure. Clin Exp Pharmacol Physiol. 2006 Sep;33(9):847-52.
Originally I’m from former USSR, and when I was 19-20 and I would get red after can of beer and so many people would say I HAD exactly same thing when I was at your age, etc. Now I don’t get red… So I don’t think it’s accurate, especially in part that says “what to do now” . Also there are women who can consumer more alcohol than most of men and stay relatively sober. Just to let you know.
I’m 70 years old and have enjoyed alcohol in moderation since I was 23. I never experienced the alcohol blush until about 4 years ago. Now I seem to experience it to some degree with any type of alcohol, but especially with red wine — face flushed, feels hot. But no other signs (rash, hives, etc) appear and I do not have high blood pressure. It seems to have developed concurrently with my taking the prescription medicines vytorin and/or toprol. Are you aware of any links between these, and why the late age onset?
Hi Robert!
Thanks for sharing with us your concern.
Sometimes medications mighthave some correlation. We recommend you checking with your doctor instead as he will have your prescription history and medical records. He will be able to do some specific checks on the spot for you as well. 🙂
Thank you so much for sharing this. I do get red faced after drinking just one beer and never really thought to much about it. Not until my face would get so darn hot I’d have to get a cold washcloth and put it on my face. I’ve always said that it my drinking was going to cause me health problems I would quit!! Well God sent me a huge message and I saw your post. Thanks so much!!
Bummer! I have so much fun when i drink/overdrink. The whole article, along with other’s shared experiences is a red flag. While the odds of it leading to that specific cancer is very slim… common sense tells one their allergy to alcohol is surely wreaking havoc to our body in many more ways than the average person whose liver can consume it efficiently. Ugh…how disappointing.
I am not aware of asian being in my family tree…. but certainly may be. Stem from Gernan brothers to Canada in 1752. I have asian flush, a daughter has it and one of 6 siblings, a sister, has it. We all get quite blotchy red in the face and down to the upper chest and upper back. I find spirits like vodka the worst. I happens to me with as little as a one oz drink. I am looking to cut back my dring a lot and to eduate both my daughter and sister.
That makes a lot of sense. I drink more than moderate and it is mostly dark whiskey. My face & neck turn red & I get very hot. I’m 45 & have been drinking since I was a teenager. I don’t remember this always being the case. Beer really doesn’t affect me. I should probably slow down.
have a raw carrot a hour before you start to drink. Try it at home! It works every time for myself!
When I was younger I drank like a fish,my cheeks would get pink but not how it does now. Now it itches too.For a long time I stopped but I wanted to be able to drink a little so I started drinking gluten free alcohol and it seemed a little better,I still flush but not itch. This may be stupid but I’m,wondering if because I’m Hungarian,I have this flush…because Mongolians occupied Hungary for awhile…just wondering,don’t mean to offend anyone.
This only started happening to me after I gave birth to my second bab . My first drink after having him 2 sios and I went bright red burning tingling face. Why would it have changed? My mum has this, is it heredatory? Why did it inky start after my second baby?
Hello everyone, reading other people’s comments and experience on this “flush” we all have deal with helps me not feel alone. I am Puerto Rican and Mexican decent. Not Asian. But my father told me it happened to him and my grandfather both from my Mexican side. My father stoped drinking because of it and my grandfather didn’t. I don’t plan on stopping anytime soon. I just don’t want to hehe, but maybe someday I will. When people ask me why am I red and yes even so red after just one beer or even one rum and coke. I tell them I’m missing something in my body to help break down the alcohol. My wife calls me hell boy as well when it happens. I did notice Pepcid ac helps sometimes and trying not to eat right before I drink helps. Basically drinking on an empty stomach works most times. I know the risk of drinking while having this flush defect. But simply don’t want to stop me from having a few well deserved drinks after a long day or a weekend watching football. Moderation is key som I choose the days I drink wisely. Well if you guys have any other tips or questions we are not alone. Keep in touch.
Thanks Jolene for the article.
As for me I’m going to do total abstensia. I get bright red after one drink.