Got A Case Of 'Red Face' When You Drink Alcohol? It's The 'Asian Flush'

by Eric Ho

Have you ever walked into a bar, or an on-campus party and noticed a certain individual’s face is bright red? Do you have a friend, most likely of Asian decent, whose face glows red after having as little alcohol as a beer or glass of wine? This phenomenon has a name, and it’s called the Alcohol Flush Reaction (AFR), or what’s popularly referred to as the “Asian Glow” or “Asian Flush.” The flush reaction is caused by an enzyme deficiency called ALDH2 (aldehyde dehydrogenases). Those affected have inherited this enzyme deficiency, and it becomes most apparent when consuming any proof of alcohol.

If you are Asian, or just someone affected by the alcohol flush reaction, you may have discovered the hard way that AFR is not something to be taken lightly. In the long term, those who suffer from AFR can become susceptible to more than just a red face. You may be asking yourself, can it be treated? What are its origins? Does missing ALDH2 put you at risk for other unknown problems?

When people drink alcohol, there are specific enzymes, such as ALDH2 in the liver, which help metabolize alcohol by converting it to acetaldehyde and then acetic acid. Researchers have determined that the enzyme ALDH2 is the main link between alcohol and genetics, and those who experience the flush have a missing or deficient ALDH2 enzyme. This enzyme deficiency is inherited from the individual’s parents.

Other symptoms of AFR include increased heart rate, dizziness, itchy skin and fatigue. Of course, the best way to treat AFR is just to avoid alcohol all together. Those who are missing the enzyme put themselves at greater risk for liver damage and other side effects.

AFR is still not fully understood, especially in terms of discovering a remedy to counterbalance its effects when drinking alcohol. Some have found that taking over-the-counter heartburn medication, such as Pepcid AC or ZANTAC, before drinking may slow down the AFR. This may be because the histamine blockers in these medication help to block the flushing associated with AFR.

There have recently been findings that suggest that those who lack the alcohol-metabolizing enzyme may be at risk for esophageal cancer. There are many forms of ALDH in the liver; a mitochondrial enzyme is located on chromosome 12. Statistically, about 50 percent, or half, of all Asians are deficient in ALDH2 and, therefore, experience facial flushing, dysphoria, nausea, and hypotension due to acetaldehyde build up when drinking alcohol. The ALDH2-deficiency, on the other hand, is less common among blacks and whites, as well as Europeans, but has been found in some Native Americans.

Since Asians are most susceptible to the AFR, which country has the highest concentration of the enzyme deficiency gene? The highest gene frequencies are in Japan, followed by significant numbers in Korea and China, as well as some in countries in Southeastern Asia, which yield large numbers of Chinese ancestry. The majority of Asians who reside in Russia, India, Australia and the Pacific Islands, Europe, Africa and America do not have the ALDH2 gene.

Most people with AFR continue to drink, regardless of their symptoms, but as expected, most of them tend to drink less because they become self-conscious when their symptoms appear, or they feel embarrassed with having a flushed face. For those who suffer from the AFR, stay thirsty and drink responsibly. Hopefully, we’ll find a cure soon, so you can drink without worry!

Top Photo Courtesy: Student Life