Alcohol Flush Reaction

This genetic condition refers to one of many physiological reactions associated with alcohol consumption. Commonly referred to as Asian flush or Asian glow, the reaction manifests as a red flushing response typically on one’s face, neck and chest after a few drinks of alcohol.  Given the social nature of alcohol consumption, many sufferers report that these physiological symptoms are also accompanied by feelings of anxiety and embarrassment.

There is a lot of information published about this disorder on the internet.  Some of it is accurate and some of it is simply wrong.  The purpose of this article is to provide a simple and understandable explanation of the nature of the disorder.

Who Is At Risk?

The flushing response to alcohol is typically, but not exclusively, experienced by Asians.  According to a 2007 study conducted by researchers M Eng, S Luczak and T Wall, approximately 36% of people of Japanese, Chinese and Korean descent exhibit a distinct physiological response to the consumption of alcohol.1 Another study concluded that the reason for this response can be narrowed down to a genetic enzyme deficiency observed to be most prevalent in Chinese-American, Japanese, Han Chinese, Korean and Taiwanese test samples.2

Causes

As mentioned above, the cause of the alcohol flush reaction 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 associated with alcohol consumption.

What we are lacking is an enzyme called aldehyde dehydrogenase 2 (ALDH2).   This enzyme is usually responsible for converting toxic acetaldehyde into relatively non-toxic acetate during the metabolic process illustrated below:

flow chart of alcohol metabolism
This flow diagram shows the metabolic process that gives rise to acetaldehyde production. In particular, the function of the ADLH2 enzyme that usually turns the acetaldehyde into non-toxic acetate and prevents it from causing a red face after drinking alcohol.

 

As a result of this deficiency, the consumption of alcohol by ALDH2 deficient individuals invariably results in an accumulation of acetaldehyde in the body.  It is the accumulation of this toxic substance that causes the alcohol flush.

Physiological Symptoms

The main physiological symptoms of the body’s reaction to acetaldehyde include:

  • Vasodilation (i.e. a widening of blood vessels) associated with an increase in one’s skin temperature
  • Hot flushing
  • Red facial flushing
  • Tachycardia (i.e. increased heart and respiration rate)
  • Lowering of one’s blood pressure
  • Dry mouth and throat associated allergic reactions
  • Nausea
  • Headache.3

Onset

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.

Severity

The severity of one’s alcohol flushing will depend largely on their body’s susceptibility to acetaldehyde and the amount of alcohol consumed.  Some individuals report experiencing the flush only on their face, whilst others describe a more hive like reaction that covers both their face and upper torso.  For some it only takes a few sips of alcohol, whilst for others it might take 1 to 2 standard drinks.

Psychological Symptoms

Given the highly social nature of alcohol consumption in our society, it is no surprise that people who experience the above mentioned symptoms often also feel very embarrassed and anxious when suffering their reactions in public.  This psychological aspect of Asian flush is more often than not overlooked in place of a purely physiological consideration of its symptoms.

Think about it.  Alcohol consumption is generally accepted in most societies as the cornerstone of socializing in a casual and professional context.  It is a common thing for people to ask each other out for a drink, to have after work drinks, client drinks, birthday drinks, going away drinks, etc.  Moreover, it is in these social and professional contexts that people want to look their best and not have to worry about red facial flushing, swelling, headaches, etc.

This is why sufferers of alcohol flush reaction are usually burdened by a social anxiety that accompanies their embarrassing physiological symptoms.  It follows that a well rounded consideration of the disorder should incorporate both physiological and psychological aspects of how sufferers are affected.

Long Term Risks

People are too often preoccupied with short term symptoms that they seldom stop to think that these reactions could be a warning sign that we are doing far more damage to our well-being than we think.  This inclination for short sightedness can often lead to the overlooking of long term risks and the development of serious underlying health issues.

In this regard, it is important for to be aware of a number of serious health warnings that are specific to people with alcohol flush.  For a detailed overview of these warnings please refer to our article about cancer risks linked to Asian flush.

Related Conditions

A condition often confused with alcohol flushing is an allergic reaction to alcohol.  Despite the apparent similarities in the short term symptoms of these conditions, the causes and dangers surrounding them are vastly different.

In short, an allergy to alcohol is very rare and usually a result of someone’s reaction to an additive used in the manufacturing of the alcohol, i.e. yeast, preservatives, flavoring, rather than the actual alcohol itself.

Unlike alcohol flush reaction, the short term symptoms of a real alcohol allergy can be potentially fatal.  This is why it is extremely important to learn more about your condition and consult with your medical practitioner before taking any action.

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?

We encourage you to view the Asian flush product reviews section of our website to gain a better understanding about the products that are currently available.

We also recommend checking out www.asianredness.com for a free and controversial guide containing specific instructions about what we can do about the flush.

References

1. Brooks, Enoch, Goldman, Li, Yokoyama [2009] “The Alcohol Flushing Response: An Unrecognized Risk Factor for Esophageal Cancer from Alcohol Consumption” PLoS Med 6(3).

2. Eng, Luczak, Wall [2007] “ALDH2, ADH1B, and ADH1C genotypes in Asians: A literature review” Alcohol Res Health 30: 22–27.

3. Eriksson CJ. The role of acetaldehyde in the actions of alcohol (update 2000) Alcohol Clin Exp Res. 2001;25:15S–32S.

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