“Asian Flush” Waves Red Flag for Cancer Risk

Two young women talking while holding glasses of wine

For some people of East Asian descent, drinking an alcoholic beverage can trigger a red face, often called “Asian Flush,” “Asian Red,” or “Asian Glow.” But the facial flushing, which can extend to the arms and chest, isn’t just embarrassing—it’s also a sign of a genetic trait that can put heavy drinkers at increased risk of alcohol-related health problems, including esophageal cancer. That risk is the focus of an article in the online journal PLoS Medicine by investigators with the National Institute on Alcohol Abuse and Alcoholism and the Kurihama Alcohol Center in Japan.

The condition, which affects about 8 percent of the world’s population, centers on a deficient enzyme, aldehyde dehydrogenase 2 (ALDH2), which controls how the body processes alcohol. About half of all East Asians have an inactive variety of the enzyme. Those with two copies of the inactive variety usually experience such strong reactions to alcohol—facial flushing, rapid heartbeat, headache, and nausea—that they avoid imbibing, because “often they do not find alcohol consumption pleasant,” notes James Marshall, PhD, Distinguished Professor Emeritus.

The danger is greater for those with only one copy, because they tend to have milder symptoms and may therefore consider the flushing to be nothing more than a nuisance. But drinking as much as two beers per day can increase by up to 10 percent their risk of developing esophageal cancer, say investigators.

While some websites advise those who experience “Asian flush” to prevent the red face by taking an antacid before drinking alcohol, the effect is only skin deep. Warns Dr. Marshall, “Those who have the condition but still drink heavily may be more vulnerable to health risks imposed by their alcohol consumption.”