What is the Asian Flush?

I’ve been wanting to write about the Asian Flush for a while now. Living outside of Asia, it is perhaps not common knowledge unless you have a lot of East Asian friends. The Asian Flush occurs when an East Asian person drinks alcohol and their face flushes after only one drink. The condition is also known as Alcohol Flush Reaction and it is something that I have.

My history with alcohol

Much like any person, as soon as I came of age to drink, I wanted to try it. This unwritten rite of passage into adulthood. I immediately was taken aback by how little I enjoyed it. My heart would start beating faster and I felt nauseated without even finishing one bottle. It didn’t help that I didn’t like drinking carbonated drinks and much of my introduction to alcohol was in the form of alcopops. I tried to conform to my peers and put much of my early experience down to low tolerance, but never actually enjoyed the process.

It wasn’t until I got to my 20s that I started giving alcohol another chance. My slow reintroduction occurred mostly in the comfort of friends’ homes. Gone was the peer pressure that occurred in my teenage years and I started experimenting by taking sips of what other people were drinking. I found I quite like the taste of some drinks and slowly started ordering my own drinks to see what I enjoyed. It was also at this stage that I knew what Asian Flush was and felt less ashamed of my experiences.

Long Island Ice Tea

What happens when you drink alcohol?

Let’s get into the science! When your body consumes alcohol, it goes through two stages. The alcohol is metabolised by a liver enzyme into acetaldehyde (toxic) and then acetic acid (harmless). Because those toxins are poisonous, when there is a high level of them, your body reacts by turning red as your blood vessels temporarily expand and fill with more blood. This can also cause other effects like nausea and sleepiness. These are things atypical of anyone who consumes too much alcohol.

How does Asian Flush differ from this?

So basically it’s down to genes. A lot of the East Asian population and some South Asians have one or two different gene variant. One variant increases the rate at which alcohol is broken down to a toxin and the other variant slows down the rate at which that toxin is broken down into a harmless acid.

I am the lucky person to have both variants (woo….ooo..oo?). Basically, my body creates toxins much earlier and keeps them in my system for longer than other people. Not all Asians have this; my siblings do not flush at all (I am cursed).

There is no “cure” for it. It’s also worth noting that those with the second variant are more prone to getting oesophageal cancer from drinking alcohol.

Me with a bit of Asian Flush

Can’t you just build up a tolerance?

In theory, yes. As with anybody, if you drink consistently your body adapts to the toxin and slows the rate it is absorbed into the bloodstream. This takes time and repetition which is probably not a good idea given the fact that alcoholism is bad and the aforementioned increased risk of cancer.

In the short term, drinking alcohol with red bull as a mixer (e.g. Jäegerbombs amongst others) can help. I’ve found I can consume more alcohol without getting to the ill part and hypothesise that this is because the caffeine or taurine contained increases my metabolism and thus I can process alcohol faster than I would normally.

So, you can’t drink alcohol?

Well, no, that’s not it. I can still drink and plenty of Asians who experience the Asian Flush do. It is, however, a strong reason why many Asians don’t drink alcohol. Some people take antihistamines (that’s your hayfever tablets) or only drink alcohol with low sulfites to reduce the redness, but that doesn’t affect how slow or fast your liver enzymes work. The combination of antihistamines and alcohol could also make you more drowsy.

I quite like the taste of some alcohol and I do love cocktails, so I will have a half glass or two depending on how much alcohol is in the drink. At the end of the day, I like to drink, I just can’t drink that much. So don’t rule me out of any drinking occasion, but do be mindful.

Steps you can take if you have Asian flush

• Make sure you aren’t hungry when you are drinking alcohol
• Make some note of how much alcohol is in certain drinks. Aim for low measures of highly alcoholic drinks, or drink them verrrryyy slowly. Alternatively, drink higher measures of low percentage alcoholic drinks. In either case, watch the speed you are drinking at.
• Try drinking alcohol with red bull as a mixer (e.g. Jäegerbombs amongst others)
• Know your limits. I often don’t start drinking until the evening is well on its way and I know when to stop before I start feeling too nauseated (most of the time)
• Don’t bow to peer pressure. Don’t be afraid to say no.
• I wouldn’t really buy into rounds either (where each person in a group takes it, in turn, to buy drinks for everyone). It’s not worth it.
• Drink at home or at friends’ homes. You know you are safe then and can have your friends look after you or offer a sofa or a bed if you do go overboard.
• Just don’t drink! There are plenty of good mocktails out there!