Face turns red after drinking

Originally Published: January 24, 2003 - Last Updated / Reviewed On: May 28, 2014
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I'm a Filipino-Chinese student who has discovered drinking recently. There is one problem, I turn really red!!! I have heard that this happens because I am Asian. I like to drink socially, but am very embarrassed by the whole red thing. What is it that causes this and what can I do about it?

— Wanna drink

Dear Wanna drink,

You're probably not the only red one in the bar; as many as 50 percent of people of Asian descent experience a flushed complexion after drinking alcohol. Alcohol flush reaction, the more technical name, describes the body's inability to break down ingested alcohol completely. You and others like you have an inactive enzyme, aldehyde dehydrogenase 2 (ALDH2), which is normally responsible for breaking down acetaldehyde, a byproduct of the metabolism of alcohol. Acetaldehyde is a toxin and if your body can't break it down, it accumulates and causes flushing. Other symptoms you might experience include dizziness, nausea, headaches, and an increased pulse.

Scientists don't know why the enzyme is inactive primarily in people of Asian descent, but it is genetic and can be passed on by either or both parents. Some researchers find that the presence of the mutation can help account for the lower levels of alcoholism in Asian communities, since many of the symptoms of alcohol flush reaction discourage people from drinking. There is some evidence that ALDH2 is inactive in higher than average levels in people of Jewish descent as well.

Because it's genetic, there isn't much you can do to prevent your red face. Tolerance levels and the severity of flushing and other symptoms vary from individual to individual, so you might want to test how much alcohol it takes before your rosiness becomes noticeable. If your coloring makes you self-conscious, sometimes the room is dark enough that people may not notice. If people do notice, they may think you are warm or excited to see them. You could also explain to any drinking partners why you're turning red, but it's likely they will soon forget about your flushed face.

There is some suspicion that a build up of acetaldehyde can cause cancer, but more research needs to be done before a definitive answer can be given. Otherwise, there are no known long-term health consequences resulting from the alcohol flush reaction.


March 19, 2012

I realize that this question was posed many years ago, however I want to include some information to people who may still come across this in search for answers of their own. I'm only a quarter...
I realize that this question was posed many years ago, however I want to include some information to people who may still come across this in search for answers of their own. I'm only a quarter Asian, yet I have the worst reaction of anyone in my family. For me, it's not just that I turn "rosy" but I occasionally break out in painful itchy hives all over my face and chest. One time I had such a severe reaction that my lips and eyelids swelled up so much that I had to take my contacts out. So much of my blood had rushed to my face that if you watched closely, you could actually see my pulse. All this was the result of less than half of one wine cooler. I was with my mother at the time, who gave me a bunch of Benadryl and drove my to the Emergency Room. The tricky thing for me is that this reaction is not consistent. I may have a shot for some random reason, and not have any ill effect, but it seems the more often I drink, the worse the effect becomes. And if it doesn't happen the first time, or the second, or even the third, when I do have a reaction it is invariably in response to the cumulative amount of alcohol that I had consumed since my last severe reaction. In other words, it may not happen this time, but at some point it catches up with me hard-care. I understand that I have a much more severe reaction than most others, but I want people who may be looking into this, to realize that there may be more to it than just being "rosy." And to please be aware, and pay attention to what your body is telling you.