Does Your Face Turn Red When You Drink? Heres Why

Alcohol and facial flushing

If your face turns red after a couple glasses of wine, you’re not alone. Many people experience facial flushing when they drink alcohol. The technical term for this condition is “alcohol flush reaction.”

Most of the time, the flushing happens because you have trouble digesting alcohol completely.

People who flush when they drink might have a faulty version of the aldehyde dehydrogenase 2 (ALDH2) gene. ALDH2 is an enzyme in your body that helps break down a substance in alcohol called acetaldehyde.

Too much acetaldehyde may cause a red face and other symptoms.

Read on to learn more about why flushing happens and what you can do about it.

Who is more susceptible?

Scientists estimate that there are at least 540 million people worldwide with an ALDH2 deficiency. That’s about 8 percent of the population.

People of Japanese, Chinese, and Korean descent are more likely to have alcohol flush reaction. At least 36 percent, and perhaps up to 70 percent, of East Asians experience facial flushing as a response to drinking alcohol.

In fact, the red face phenomenon is commonly referred to as “the Asian flush” or the “Asian glow.”

Some research has also shown people of Jewish origin might also be more likely to have an ALDH2 mutation.

It’s not known why certain populations are more likely to have this problem, but it’s genetic and can be passed on by one or both parents.

What’s happening?

ALDH2 normally works to break down acetaldehyde. When a genetic change affects this enzyme, it doesn’t do its job.

An ALDH2 deficiency causes more acetaldehyde to build up in your body. Too much acetaldehyde can make you intolerant to alcohol.

Flushing is one symptom, but people with this condition might also experience:

• rapid heartbeat
• headache
• nausea
• vomiting

Is it dangerous?

While the flushing itself isn’t harmful, it may be a warning sign of other risks.

One 2013 study showed that people who get flushed after drinking may have a higher chance of developing high blood pressure.

Scientists looked at 1,763 Korean men and found the “flushers” who drank more than four alcoholic beverages a week had a greater risk of developing high blood pressure compared to those who didn’t drink at all.

But, the “non-flushers” were only more likely to have high blood pressure if they had more than eight drinks a week.

Having high blood pressure can increase your chances of heart disease and stroke.

A 2017 review of 10 different studies found that facial flushing response to alcohol was associated with higher cancer risk, particularly esophageal cancer, in men in East Asia. It was not associated with cancer risk among women.

Some doctors believe that the flushing effect might be helpful in identifying those at risk for these diseases.

Treatments

Medicines called histamine-2 (H2) blockers can control facial flushing. These drugs work by slowing the breakdown of alcohol to acetaldehyde in your bloodstream. Common H2 blockers include:

• Pepcid
• Zantac
• Tagamet

Brimonidine is another popular treatment for facial flushing. It’s a topical therapy that lessens facial redness temporarily. The medicine works by reducing the size of very small blood vessels.

The U.S. Food and Drug Administration (FDA) approved brimonidine for the treatment of rosacea — a skin condition that causes redness and small bumps on the face.

Another topical cream, oxymetazoline, was approved in 2017 to treat rosacea. It may help facial redness by narrowing blood vessels in the skin.

Some people also use lasers and light-based therapies to reduce redness. Treatments can help improve the look of visible blood vessels.

It’s important to know that therapies to help flushing don’t address the ALDH2 deficiency. They can actually mask important symptoms that could signal a problem.

Can I prevent it?

The only way to prevent facial flushing from drinking is to avoid or limit your alcohol consumption. This might be a good idea, even if you don’t have a problem with turning red.

According to the World Health Organization (WHO), alcohol is responsible for more than 5 percent of deaths worldwide.

WHO says that alcohol is a “causal factor” in more than 200 diseases and injuries.

Too much alcohol can increase your risk for developing a host of medical problems, including:

• liver disease
• certain cancers
• high blood pressure
• heart disease or stroke
• memory problems
• digestive issues
• alcohol dependence

If you do drink, try to drink moderately. The Dietary Guidelines for Americans defines “moderate” drinking as up to one drink a day for women and up to two drinks a day for men.

Cautions

Medicines that disguise the symptoms of alcohol intolerance may make you feel like you can drink more than you should. This can be dangerous, especially if you have an ALDH2 deficiency.

Remember, flushing in the face may be a sign that you should stop drinking.

The bottom line

Facial flushing while drinking is usually due to an ALDH2 deficiency, which may make alcohol consumption more harmful to your health. People of Asian and Jewish descent are more likely to have this problem.

While treatments may hide the redness, they only cover up your symptoms. If you experience facial flushing while drinking, you should try to limit or avoid alcohol.

Talk to your doctor if you think you might have an ALDH2 deficiency. Tests are available to confirm that you have the altered gene.

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