Getting a red face after downing alcoholic beverages is not a sign of strong qi (energy flow) or good blood circulation, but rather, it is an indication that your body is not metabolising alcohol efficiently. This phenomenon c​​alled “Asian flush syndrome” is common among Asians of Chinese, Japanese and Ko​​​rean descent.

“If you are Asian and drink alcohol frequently, you may have a higher risk of getting stomach or oesophageal cancer or peptic ulcers due to a genetic inability to efficiently process acetaldehyde, a toxic by-product of alcohol metabolism,” says Dr Tan Ek Khoon, Associate Consultant at the Department of Hepato-pancreato-biliary and Transplant Surgery, Singapore General Hospital (SGH), a member of the SingHealth group.

The main method that the body metabolises or breaks down alcohol is dependent on two enzymes:

  1. Alcohol dehydrogenase which first converts alcohol into acetaldehyde and
  2. Acetaldehyde dehydrogenase (ALDH2) which breaks down acetaldehyde into harmless compounds.

Due to genomic differences, 80 per cent of Asians have an overactive alcohol dehydrogenase. Hence, they break down alcohol into acetaldehyde very quickly – even up to 100 times quicker. Since alcohol is broken down faster, this is why you might experience little to no alcohol “buzz”.

On the other hand, most Asians have an inactive variant of the second before-mentioned liver enzyme ALDH2. This means that the by-product acetaldehyde takes a much longer to clear from their blood.

Asian flush syndrome increases risk of certain diseases and cancers

The build-up of acetaldehyde is what causes blood vessels to dilate and the face to turn red - the so-called “Asian flush syndrome”. The problem goes beyond aesthetics: Acetaldehyde is more toxic than alcohol and a known cancer-causing agent.

“Acetaldehyde can trigger inflammation in the upper gastrointestinal tract, cause DNA damage, and increase one’s risk for gastrointestinal diseases, namely oesophageal and stomach cancers as well as peptic ulcers,” says Dr Tan.

If you have Asian flush syndrome and drink two beers a day, your risk of oesophageal cancer is up to 10 times higher than that of a person who has normal ALDH2.

Signs of Asian flush syndrome

  1. Facial blushing
  2. ​Rapid heartbeat
  3. Nausea
  4. Headaches

Read on for tips on coping with the Asian Flush Syndrome.


Ref: P16