When an individual gets a red face after drinking alcohol, people will generally think of the syndrome called Asian flush. Also sometimes called alcohol flush reaction, what we are in fact colloquially referring to here is one of the many externally observable reactions to a collection of underlying genetic abnormalities that prevent the proper metabolism of alcohol. In this regard, it is actually a reaction to a condition, not a condition in and of itself.
Who is at risk?
The flushing response to alcohol is typically, but not exclusively, experienced by Asians. According to a 2007 study examining the effects of ALDH2*2 on alcohol problem trajectories of Asian American college students, approximately 36% of people of Japanese, Chinese and Korean descent experience Asian flush.
A subsequent literature review examining ALDH2 genotypes in Asians confirmed these findings, further adding that:
The ALDH2*2 allele appears to be most prevalent in Chinese-American, Han Chinese and Taiwanese, Japanese, and Korean samples. Much lower rates have been reported in Thais, Filipinos, Indians, and Chinese and Taiwanese aborigines
Individuals usually report feeling a warm numbness or tightness in their face 10 to 20 minutes after consuming alcohol. This then escalates to more of a pulsing or throbbing feeling and coincides with the skin around the eyes and face turning red. The facial redness and other symptoms usually remain for about 1 to 2 hours depending on the amount of alcohol consumed.
The flushing reaction is a hyperemia induced erythema, typically associated with but not isolated to superficial capillaries in the facial region. More simply put, it is a redness of the skin caused by increased blood flow to near surface veins in the affected areas. This red facial flushing is the most noticeable of many symptoms and is caused by build up in the body of a substance called acetaldehyde, a toxic byproduct of alcohol metabolism.
Learn more about Asian flush symptoms.
Causes & Triggers
Asian flush is genetic, i.e. you’re born with it. This doesn’t mean you have some kind of disease from birth until you die. In fact, it is precisely what we don’t have that gives rise to all the problems.
What we lack is an enzyme called aldehyde dehydrogenase 2 (ALDH2). This enzyme is usually responsible for converting toxic acetaldehyde into relatively non-toxic acetate during the metabolism of alcohol.
On the one hand, people with this genetic variation tend to metabolize alcohol faster and in turn produce more acetaldehyde in a shorter period of time. This is further complicated by another genetic deficiency in an enzyme that is normally responsible for breaking acetaldehyde down into a non-toxic substance. These two genetic factors contribute to the acetaldehyde build-up and are amongst the main, but not the only, causes of Asian flush syndrome.
Learn more about what causes Asian flush.
Whilst symptoms can be uncomfortable for the drinker, the short term risks are minor and more likely associated with alcohol intoxication rather than anything to do with the condition itself.
Moreover, given the discomfort typically experienced by drinkers who have this condition, it is much harder to get sufficiently intoxicated to the point where they are at risk from over intoxication. In this regard, Asian flush has been seen as a safeguard that prevents individuals from the various risks that face regular drinkers, such as alcoholism.
Importantly, this condition should be distinguished from other related conditions that pose significant short-term risks to the drinker, such as an allergy to alcohol.
In contrast to the minor short term risks, the long term risks are real and significant. Numerous governmental health bodies have flagged acetaldehyde as a known carcinogen and have publicly warned people with Asian flush of the health risks that arise as a result of continued alcohol consumption. In this regard, it is extremely important to be aware of these health risks, drink alcohol in moderation and follow appropriate safety measures to avoid prolonged acetaldehyde build up in your body.
Learn more about Asian flush health risks.
Conditions often confused with Asian flush are the various allergies associated with alcohol. Despite the apparent similarities in the short term symptoms, the causes and dangers surrounding them are vastly different.
Learn more about conditions related to Asian flush.
Real Life Experience
This video was posted by a fellow sufferer of Asian flush. She describes some of the physiological symptoms discussed above along with the accompanying feelings of embarrassment commonly reported by surveyed subjects.
At the end of the video she makes a very good point. This is something that a lot of people go through and, as she so rightly states, there must be something we can do.
What Can We Do?
There is currently no treatment for the underlying genetic condition mentioned above. However, as discussed, Asian flush is a reaction to this condition and not a condition in itself. This reaction can be easily and effectively minimized with appropriate treatment.
Getting informed about your condition is the first thing you should do, so take time to digest the information presented in this resource.