What causes alcohol flush reaction? – Image The alcohol flush reaction is a type of alcohol intolerance—not an “alcohol allergy”—and is a condition predominantly due to inherited variations in genes of certain enzymes, causing people to metabolize alcohol less efficiently. During alcohol metabolism, the enzyme alcohol dehydrogenase (ADH) converts alcohol to acetaldehyde, a toxic molecule.
The resulting acetaldehyde is metabolized to nontoxic molecules by another enzyme called aldehyde dehydrogenase (ALDH). If acetaldehyde is not metabolized efficiently, it can cause release of histamine and thereby trigger flushing and other unpleasant symptoms. Variations in the alcohol dehydrogenase gene, ADH1B, and the aldehyde dehydrogenase gene, ALDH2, are well-known variations that lead to higher acetaldehyde levels due to altered alcohol metabolism and are more common among people of East Asian ancestry.
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How to Stop Asian Glow / Stop Asian Flush
People of other races and ethnicities, however, can also carry these variations. People who take certain medications that alter alcohol metabolism can also experience the alcohol flush reaction. Such medications include those used to treat diabetes, high cholesterol, and infections.
Why do I get flushed when I drink alcohol?
Should I be worried? – You may be asking yourself this question if you’ve ever experienced facial flushing. On the surface, facial flushing might feel cosmetically embarrassing at most and may not come with any other dangerous symptoms. For those with an enzyme deficiency, facial flushing can occasionally be experienced with increased onset of nausea or vomiting because of your body’s inability to fully digest the alcohol you’re consuming.
For the most part, these factors are mostly harmless. But because alcohol is a cellular toxin, anyone who drinks excessively increases their risk for oral cancer and esophageal cancer, “Alcohol most frequently passes through these sites,” states Dr. Vij. “Toxicity and DNA damage can build up in cells and, eventually, a cancer can form.” But recent studies report that those who get an alcohol flush because of an enzyme deficiency are also at heightened risk of digestive, liver and respiratory cancers,
These populations are more vulnerable to alcohol’s toxicity, as it’s processed and later eliminated in:
Your gastrointestinal (GI) tract, especially your stomach, where alcohol is absorbed. Your liver, where alcohol is sent after it’s absorbed by your stomach. Your lungs, where alcohol in your blood is released in your breath.
Is alcohol flush bad?
Some people’s faces flush after drinking alcohol. If the body cannot metabolize alcohol effectively, too much of a substance called acetaldehyde can build up. This is toxic and can cause a histamine release, resulting in flushing and other symptoms. People with certain genetic features have a higher chance of flushing. 
Share on Pinterest A red face after drinking alcohol may be a symptom of high alcohol sensitivity. Facial flushing after drinking alcohol is a symptom of high alcohol sensitivity, which means that the body is less tolerant of alcohol. All alcoholic drinks — including beer, wine, and liquors — contain a substance called ethanol.
After having a drink, the body begins to break down the ethanol into other substances, or metabolites, to make it easier to flush out of the body. One of these metabolites, acetaldehyde, is very toxic to the body. When drinking in moderation, the body can usually process these metabolites relatively well.
However, if a person is sensitive to alcohol or has a lot to drink, their body may not be able to manage all of those toxins, and acetaldehyde can begin to build up in the body. The red facial flush happens because the blood vessels in the face dilate in response to these toxins.
In some people, this can happen after very little alcohol. A buildup of acetaldehyde can also cause nausea and a rapid heartbeat. These symptoms may make drinking alcohol an unpleasant experience, leading to people drinking less. While the red flush itself is not acutely dangerous, people who get it are at higher risk of high blood pressure and other health problems.
A 2013 study of Korean men looked at the differences in blood pressure between men who did and did not experience facial flushing when they drank alcohol. After taking factors such as age, weight, smoking, and exercise into account, the researchers found that men who flushed after drinking alcohol had a significantly higher risk of high blood pressure when they drank four or more drinks per week.
- In contrast, men who did not flush after drinking did not see an increased risk of high blood pressure until they drank eight or more drinks per week.
- Studies have also associated drinking alcohol with certain types of cancer.
- Some researchers believe that this increased cancer risk could be due to the rise in acetaldehyde levels in the body.
High levels of acetaldehyde can attack the DNA in the cells of the body, which can trigger the growth of cancer cells. In a 2017 study, researchers looked at the link between cancer and facial flushing after drinking in people in East Asia. Men with facial flushing had a higher risk of cancer, particularly cancer of the throat, which is also called esophageal cancer,
The researchers did not find the same association in women. Whether or not a person’s face goes red after drinking seems to link to their genetic makeup. A liver enzyme called aldehyde dehydrogenase 2 (ALDH2) breaks acetaldehyde down into less toxic substances. Some people have a genetic condition that means that they do not make this enzyme.
As a result, acetaldehyde builds up in the body after alcohol consumption, which causes the characteristic red flushing of the face. Although anyone can lack this gene, it is more common for people from East Asia not to have it. There is no way to change the genes or enzyme deficiency.
The only way to prevent this red flush and the associated risk for high blood pressure is to avoid or limit the intake of alcohol. Some people use over the counter antihistamines to reduce the discoloration. However, this is not advisable. Although some people may find the flushed skin embarrassing, it is a signal that the body is accumulating toxic levels of acetaldehyde and that it is time to slow down and rehydrate with water.
It is important to recognize that even people who do not get this type of reaction when drinking are still at risk of the health complications of alcohol use, including high blood pressure, liver disease, cancer, and stomach problems. The red flush that some people get while drinking alcohol may not seem serious, but it can indicate that someone has a higher alcohol sensitivity and may have an increased risk of high blood pressure and certain cancers.
While taking antihistamines can help reduce the redness, these drugs only hide the symptoms and do not address the underlying cause. The Centers for Disease Control and Prevention (CDC) recommend that if people choose to drink, they do so in moderation. They define moderate amounts as one drink per day for women and two drinks per day for men.
If a person has high alcohol sensitivity, meaning a low tolerance to alcohol, they may feel the effects of alcohol more strongly and quickly and may benefit from drinking less alcohol. People who are concerned about this symptom can talk to their doctor for advice.
How common is alcohol flush?
What is Alcohol Flush Reaction? – Alcohol Flush Reaction is a symptom that can be part of a condition known as Alcohol Intolerance. Alcohol Flush Reaction causes a person’s face to become red when they drink alcohol, even a small amount (less than a standard drink).
- This flushing is due to an increase in the compound Acetaldehyde, a compound that is a byproduct of the metabolism of alcohol in the body.
- People with Alcohol Flush Reaction lack the enzyme aldehyde dehydrogenase 2, an enzyme that helps aid in processing alcohol in the body (ncbi.nih.gov).
- Since people with Alcohol Flush Reaction can not process alcohol normally, they are especially sensitive to it and their alcohol tolerance is lower.
This condition occurs in around 8% of the general population and is more prevalent in people with East Asian descent, occurring in around 36% of East Asian people (ncbi.nih.gov). Doctors can test if a person has Alcohol Intolerance through a skin or blood allergy test.