Do You Turn Red After Half a Beer? You Could Have Alcohol Flush Reaction

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).

Source: physrev.physiology.org

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.