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March 25, 2009

Why the red face? Alcohol flush could mean increased cancer risk

Posted: 03:48 PM ET

By Madison Park
Writer/Producer CNNhealth.com

Immediately after taking a few sips of an alcoholic drink, I have an almost cartoonish reaction. I burn up and turn scarlet – my whole face, forearms and neck.

My response to alcohol is so strong that a martini is enough to make me vomit, and half a bottle of beer makes me ill. Don’t even get me started about wine.

The facial flush, also known as “the Asian glow,” is a fairly common reaction to alcohol amongst East Asians. They turn red, feel nauseated, get swollen and their heartbeats race. I liken the experience to turning into a bright red disco ball. Some people get so embarrassed about this reaction to alcohol, they pop in Pepcid AC, which many people say helps mask the red face.

Researchers from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and Japan's Kurihama Alcohol Center found that individuals who get the redness after drinking alcohol are at greater risk for developing esophageal cancer.

About eight percent of the world’s population has this genetic condition (Thanks, Mom and Dad), where the body lacks an enzyme that properly breaks down alcohol.

This missing enzyme called aldehyde dehydrogenase 2 metabolizes alcohol into acetate, which is non-toxic - so the remaining 92 percent of the world can drink with normal facial color.

But when I drink, the alcohol turns into acetaldehyde, which is a chemical that causes DNA damage and has cancer-promoting effects. That causes the facial flush, according to scientists from NIAAA.

Researchers whose work was published this week in PLoS Medicine say that people who have the facial flush and continue to drink are six to 10 times more likely to develop esophageal cancer, compared with someone without the genetic condition who is drinking the same amount.

And esophageal cancer carries a five-year survival rate of 12 to 31 percent.

For Lent, I gave up alcohol and I don’t miss the headaches, redness, or vomiting. So this might become permanent, because I think my body is trying to tell me something.

Do you have strange reactions to alcohol? How do you deal with it? And has this deterred you from drinking?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

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Prasad   March 25th, 2009 4:52 pm ET

Alcohol is bad and injurious to our health. In fact many old civilization condemn consumption of alcohol.
On one hand we say it causes cancer on other hand we say liitle red wine is good for heart.
But overall it is heavy for our liver to digest it, eventually kiing our liver.

Doctors wont say boldly that just dont give up, I guess they must be getting money from these wine lobbist.

It was only decade ago, we accepted universally smoking is bad for us, thanks to some of the corageous people (See 'Insider' movie).
Hope soon it will be accepted universally that alcohol is equally (in fact more) dangerous.

So many families are broken, kids and wife are beateb due to alcohol abuse.
Its time to clean our society, don't say "drink wisely" but just 'Give up drinking'
I hope this message goes on someone ears.

Melissa, Los Angeles   March 25th, 2009 7:28 pm ET

As an Asian I do get the facial flush with just one drink which is why I don't bother drinking. I don't like being hot and the red face is embarrassing.

Max   March 25th, 2009 9:10 pm ET

Well this is unsettling news, but not particularly surprising. As a male of northern european descent I also have this reaction with alcohol. The only solution I've discovered that works surefire is a second generation H2 histamine blocker, Tagamet. Pepcid AC, conversely while in the same family of medication is relatively ineffective in combating the redness. I've said it numerous times and I'll say it again here, a company really should pay attention to this phenomenon that occurs and market an OTC supplement for it. It would also be of interest to see what in fact happens with the alcohol as it breaks down with Tagamet in one's system.

cj   March 26th, 2009 2:14 am ET

Interesting article. I once knew chronic alcoholic (caucasion) who was constantly red in the face.

I can only drink beer and wine, even small amounts of hard liquor make me nausious. When I drink beer or wine I start sweating...a lot, after about half a glass.

As for previous comment, lots of people manage to drink responsibly and in moderation and don't become abusive. Alcohol has played a role in many societies since ancient times. Those people with drinking problems need help to give it up. If they're abusive when they drink, there are probably larger issues at work not related to alcohol.

Some people shouldn't drink, but that doesn't mean we should take it away from everyone. If some people drive recklessly, do we ban cars?

Last time they banned alcohol, we got organized crime.

Cyn   March 26th, 2009 9:24 am ET

I am not much of a drinker, maybe I'll drink one beer every six months...a few vodka screwdrivers every two months...But, I have an odd reaction. I can not drink anything fruit derived.....wine, champagne, wine coolers.....and I can not drink anything colored....ie whiskey, tequila, rum etc. It makes me instantly nausaus and I vomit...for hours later I suffer...In the past 20 years, I have only been able to drink vodka, very little gin, white rum and everclear(not everclear anymore however). I am so glad I rarely drink because this would be annoying. I found a related condition once on a martini recipe site, but I can't recall the name. I'm just glad its not all in my head.

Christa   March 26th, 2009 11:00 am ET

My face turns red when I drink and I've always wondered why! I feel warm, especially my face. Sometimes it bothers my stomach, but I don't vomit or have headaches.

Thanks for the information, it really helps to have an understanding.

ROBYN   March 26th, 2009 1:25 pm ET

FINALLY!!! I had no idea why this was happening to me, my mothers side is Japanese and hear it had to do with that , but never knew the truth. I actually stopped drinking all together years ago(I am 31) but not from the red face. All my friends would tell me about my face and joke about it, but I was always sick and had a hangover even if i drank a little bit the night before.

Andy   March 26th, 2009 1:54 pm ET

Look, many of the elders in family have been drinking red wine since their late teens, almost always for dinner. My mother's father and two of his siblings are still alive and well – 70+. I guess a large part of it has to do with genetics.

TexasGal   March 26th, 2009 3:08 pm ET

I'm caucasian with some Native American blood and I get red and splotchy from drinking, but no swelling (or vomiting unless I've had a large amount to drink). I've always thought that I my body had trouble metabolizing alcohol; I say this because I often experience "delayed drunkeness" where I'm coherent one moment and then totally intoxicated the next (like flipping a switch). Either way, I've learned that staying away from alcohol is the best remedy!

Re   March 26th, 2009 4:51 pm ET

alcohol gives me acid reflux... it takes forever to alleviate it and if I drink again it starts all over.. i'm not sure why this is, but i find it interesting that the lack of aldehyde dehydrogenase 2 is correlated with an increased risk for esophageal cancer (as is acid reflux)... I wonder if this is all connected?

in addition to acid reflux it also affects my stomach, i always feel nauseated the next morning, even if i dont drink much... never get a headache though.

Kelly   March 27th, 2009 9:31 am ET

I am of Irish and American Indian decent. I feel warm and, especially when drinking wine, will have flushed cheeks and neck. I thought I was just allergic.

Peg   March 28th, 2009 11:17 am ET

there is a rumored fact that alcohol thins the blood & that is why flushing of the face occurs. if wine thins the blood, then people would not to take baby aspirin or other meds.

Kendra   March 29th, 2009 2:37 pm ET

I have this...occasionaly. Does it work that way? Sometimes it causes redness...sometimes it does not? Can you metabolize correctly sometimes (produce or have the necessary enzyme) and other times not? What could cause the experience to be occasional?

I am caucasion and my identical twin sister and I turn red (sometimes) when we drink (type does not matter, wine, champagne, liquor, beer). Faces, neck, chest and sometimes arms. No upset stomach but hotness in cheeks. There is no information available that I can find regarding other causes and/or why it may only happen sometimes.

Dawn   April 1st, 2009 4:18 pm ET

I am so glad Im not the only one..I thought just maybe that it raises my blood pressure..Its only when I drink , after the first to second drink,.Though I make my drinks a bit strong.. I want to know more about this, how can I find it?

Christianne Wa   April 6th, 2009 3:53 pm ET

Thank you for sharing your personal experience with Asian glow. You write about how “you burn up and turn scarlet.” What’s funny is that I know some people who actually take Pepcid AC to prevent the glow. I would like to know how Pepcid AC actually works. How does it treat the glow, or should I say hide? Given this new discovery, it looks as if “masking the red face” may not be a good idea if the acetaldehyde is still able to cause DNA damage and promote cancer. Is there a way to add the aldehyde dehydrogenase 2 enzyme so that ALDH2-deficient patients can finally metabolize alcohol into acetate? Moreover, if acetaldehyde has cancer-promoting effects, are there current drugs or treatments that can eliminate it? I agree with Max when he said a company should really market an OTC supplement for it. I think there would be a high demand for such a product.

You mention a lifestyle change in your entry, in that giving up alcohol for Lent may become permanent. Would you suggest that other ALDH2-deficient people follow suit? This increased risk for esophageal cancer is a serious consequence of drinking. Thus, how should we educate the public about the possible carcinogenic effects of alcohol? Should doctors start asking about the glow during routine check-ups?

Jodie   April 13th, 2009 8:08 am ET

When I had an allergic reaction to a medication, the hospital gave me Pepcid or Tagamet because it has an antihistamine property to it. I too have been having the red face – with only a few swallows of White Zinfindel the other night, so this is not because of too much alcohol. I am not of Asian descent, but am about 1/16 mix of Native Amercan descent. I do not recall if beer does the same thing. I have alcohol very infrequently and I find this reaction strange and wonder why it just developed at age 34 or 35. I am allergic to Bactrim and Imitrex, which both have sulfonomides in them, so I wonder if alcohol has something in them I cannot metabolize like the sulfonomides. This makes me wonder if that missing enzyme is connected to both reactions and what the connection is to the increased cancer risk.

johnny   April 25th, 2009 5:38 pm ET

thanks every1 gr8 knowing am nt alone,am irish,white n cudn understand t it hapnd.hate it and feel anti social when i leave the pub because of it.i am going to try sum of your ideas n c wat hapens.mayb not all bad tho it stops me drinking alot but a little be nice.slan

Richard   June 15th, 2009 4:12 pm ET

Note to Kendra:
I'm in your category of red flushing. Sometimes when I drink, I get the flush, and sometimes not. It also doesn't have anything to do with the type of alcohol I consume. My flushing has only recently started and I thought this might be due to age (I'm 60, Caucasian, Irish-descent). It would seem , though, if you're missing aldehyde dehydrogenase 2, then you would flush all the time. I wonder if your body can have the enzyme but for some reason, it can be turned-off from time-to-time?

Janice   June 18th, 2009 9:13 am ET

I turn red (whole face, body, arms, legs, every where), swell, increase heart rate, my lips get numb, nausious, heart burn... Kind of severe.

I have recently drank this NON-alcohol wine and i got the same symptom, i was really surpriced. I immediately checked out the ingredients in it, there are 3 things that have a higher chance of causing my severe reaction, however, i searched online and i found it might be this one: metabisulfite. usually found in alcohol.

I'm not sure if the findings above have tested ONLY the alcohol element or only certain types of beer, wine or what. I would also want to know if anyone know, does all beer, wine and stuff have this element in it?

tcb   June 30th, 2009 2:59 am ET

I noticed that several people who commented are of Irish descent. Me too! Wonder if there is something in the Irish heritage like what is suggested for the Asian heritage? Anyone know of any studies?

Angie   July 2nd, 2009 8:35 pm ET

I also have this condition. I am not of Asian descent but I am a small percentage Native American. I first found out I had this condition when I had my first communion; all it took was one sip of wine. In college I tried every type of alcohol I could think of with my friends and all it ever took was a couple sips to make my face turn beet red and feel like it's on fire. My face literally radiates heat. Once I drank almost an entire beer (trying to see if the flushing would go away if I kept drinking) and I felt so sick and had a headache for hours. I was completely unaware of the links to cancer and find this very interesting. I will definitely have to do some more investigating.

A Wms   July 3rd, 2009 3:30 am ET

I am an African American female and when i consume any liquid that contains alcohol it causes my face to swell, it feels hot to the touch, Its kind of creepy. I can actually feel my face swelling. It was enough to stop me from drinking ( That was 5 years ago). Recently I tried a couple (2) of sips of an apple martini and I my face became very warm and i had some swelling. i immediately drank about 16 ounces of water back to back to flush the alcohol out of my system. The flush and swelling stopped about 2 hour after trying the martini. No more drinks for me!!!!

shawn fernandes   July 6th, 2009 8:38 am ET

sir ,my face swells so much that even if i drink ,people ask me if i had lot last night or what like whic makes me so emrassed .my eyes also look red .sir give my some good solution .............thank u for ur help

Anon   July 14th, 2009 4:56 pm ET

I never went red after/while drinking alcohol until may 2006 (I was 18 then). I had a pint of some foreign beer and the guys I was with started asking me 'are you okay? You look really red'. Great.
And now I don't always go red, mostly when I drink vodka (avoid vodka, great idea. I LIKE it okay?)
If it's truely genetic then surely I should have been suffering from all this as long as I've been drinking, anfd every time I drink, right?

Anthony Salatino   August 14th, 2009 11:37 am ET

Hello. I was reading about the girl who gets red face. I don't get the red face but I have some strange symptoms as well when I consume alcohol but not everytime. The first time it happened to me i was drinking Capn Morgan's and coke. I hadn't finished the drink when I started getting flushed, warm, from my neck up and my arms start to tingling and numbness. Gaseous symptoms begin in my upper abdomen like I have bad gas. It happened again with a margarita and again with a beer. What could this be? I went to my doctor and they just told me to not drink. But I want to find out what is wrong. Like I said it doesn't happen all the time so I can't pinpoint a common thread besides liquor.
Deeply concerned,
Anthony Salatino Cleveland, Ohio

heltmanna   September 14th, 2009 6:37 am ET

I've never been interested in alcohol, but when I did drink, I noticed a really irritating redness on my cheeks and forehead. Everybody in the room had to comment on it. This made very self-conscious, and I promised myself never ever to drink in public – it's so embarrassing!

I didn't, however, feel nausea or headaches. Alcohol has a nice sensation, but if it comes with a beetroot-colored face, then no thank you!

I'm only half Asian, half Caucasian. Really, thanks Mom.

Claire   October 19th, 2009 9:41 pm ET

Hello. I find it interesting that the common theme is Asian, Native and Irish.

I'm Irish with a great grandmother who is native. I've never experienced any of this until now.

Tonight I took one sip of a dark ale and my cheeks flushed instantly. Usually I do look a little flushed but only to the point of a natural blush.

Tonight my face scorching hot and puffy. I drank about half and felt very odd. I decided to stop drinking. My dad then noticed my face and we couldn't believe the reaction I had/currently suffering from.

I'm glad I found this stream of thought to calm suspicions of allergy since this is something I've never thought about. I'm worried about drinking again. Maybe it's a sign lol. I'm going to research more into this now.

Tammy Ferrell   October 20th, 2009 11:04 pm ET

I too often have this reaction when I drink, although not quite so severely. It does not happen every time though. Most often it is when I drink beer. I drank quite a lot when I was younger and NEVER had this reaction. When I was in my late twenties/early thirties it started. I only drank in moderation at that time. It would only happen a few times a year. Now I have a dring maybe once a month and it happens almost every time. If it is a missing enzyme that causes this, why did it happen so suddenly and not until that age?

Leigh   October 28th, 2009 10:40 pm ET

All these post are making me feel better. I am in my early 40's and have always drank. I have never gotten red in the face until just this week! I thought I would lay off drinking for a couple of weeks and then when I just had 1 glass of wine. My face turned so red I thought I must be getting sick! I didn't feel bad but my face felt like it was burning up and it was very flushed. Glad to hear that I am not the only one!

Wynn Capps   November 6th, 2009 10:06 pm ET

I too had a TGA attack. The Dr's suspected a stroke however in my case they did not find an answer (this was a very well known trauma 1 hospital in Fort Worth, TX) and sent me home telling me I could expect to have a major stroke in 24 to 48 hours. Needless to say I didn't sleep for 48 hours nor did my wife. A close friend, a Dr. at a teaching hospital went to their neuro science department and discussed my situation with the Dept. Head. He was told it was TGA which he relayed to me. I informed the Dr. at the hospital I was taken to and he called back within a 1/2 hr and confirmed that it was TGA. I have not had a reoccurence but it was a monday morning and we had had sex prior to leaving for work. No more sex on Monday mornings :)

Bridget   December 21st, 2009 3:11 pm ET

My boyfriend does experience this but it is not every time he drinks? Also he is not of Asian decent? I wonder if it is the same thing or perhaps some other reason either way when it does happen it is certainly very scary although he says he feels no symptoms he just looks like something is very wrong.

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