“Why are you so red?” If I had a dollar for every time I got asked that question on Thursday nights, I probably wouldn’t have to worry about my post-college debt. Okay, that’s an exaggeration; but still, it’s a ridiculous amount.
Let me answer your question cumulatively. Alcohol flushing is a common phenomenon that affects East Asians – specifically, around 50 percent of those of Japanese, Chinese, or Korean descent – hence, giving it alternative name: “Asian glow.” Symptoms include nausea, dizziness, headache and a rapid heartbeat. While these other symptoms are concerning, the central issue for most people experiencing this condition is the reddening of the face, neck and shoulder area, which typically occurs at a fast rate. And when I say fast, I mean one or two shots of vodka in fast.
Here’s the scientific breakdown. Upon consumption, alcohol is first metabolized to acetaldehyde. Acetaldehyde is a carcinogen, harmful for both humans and animals due to its ability to lead to cancer. Under normal circumstances, acetaldehyde is converted and metabolized to acetate with the help of aldehyde dehydrogenase 2 enzymes. However, a variant mutation in the alleles of the ALDH2, the gene that produces aldehyde dehydrogenase 2, may cause an ALDH2 deficiency. This leaves more and more acetaldehyde in the blood upon continued consumption of alcohol.
One allele, glutamate, generates a protein that gives this enzyme its typical catalytic ability. Another allele, lysine, generates a protein that is inactive. A person with two identical glutamate alleles experiences normal ALDH2 activity. A person with one of each allele, a heterozygote, is exposed to less than half of normal ALDH2 activity. However, someone with two identical lysine alleles, a homozygote, experiences a lack of ALDH2. It was found that the homozygote with two lysine alleles experienced the worst symptoms largely due to higher acetaldehyde levels compared to the heterozygote’s.
This genetic mutation may not be a curse, but rather a warning for long-term health. From the results of studies conducted by researchers at Aichi Cancer Center Research Institute in Nagoya, Japan, the National Cancer Center in Tokyo and the University of Tokyo, heavy drinkers experiencing alcohol flushing had a higher risk of developing oral, pharynx and esophageal cancer in comparison to heavy drinkers who did not have this genetic mutation. All studies stated that this risk was not significant for light or non-drinkers.
Neither the degree of flushing nor the rate at which it occurs necessarily correlate to one’s level of alcohol intoxication. Even if someone is extremely red, this does not mean they are drunk. Yet, to unaffected people who are not aware of the ins and outs of alcohol flushing, this correlation may seem true. Exaggerated concern or attention may leave those with this condition feeling anxious, ridiculed or even ostracized.
Thus, people with alcohol flush may wish to combat the visible symptoms of this particular genetic mutation. A solution can be found in antihistamines like Pepcid AC and Zantac.
Usage of anti-histamines, like Pepcid AC and Zantac, work like so: Increased acetaldehyde stimulates the release of histamine. Histamine, among other effects, leads to the dilation of blood vessels when bound to H1 or H2 receptors – hence leading to the reddening of the skin. In a study targeting the effects of Benadryl and Tagamet, antihistamines were found to block the same receptors from histamine and slow the increase in blood flow to the skin, an effective method to reduce flush.
However, these antihistamines were not designed to specifically combat alcohol flushing. Zantac treats conditions that arise when there is an overproduction of acid in the stomach. Pepcid AC similarly decreases the production of acid in the stomach, used commonly to treat ulcers or heartburn. Both of these drugs serve a dual function when targeting alcohol flushing.
The effect of the antihistamines on alcohol metabolism, when taken in combination with alcohol, is still largely unknown. One study from the Jikei University of Medicine in Tokyo, suggests that using antihistamines actually increases alcohol metabolism, while other studies establish that a minimal effect on alcohol metabolism was observed.
The genetic predisposition to alcohol flushing is theorized to be a protection against alcohol, especially among East Asians, effective in its immediate display of threat to the body through flushing. This high sensitivity to alcohol may deter many to consume less. Thus, using antihistamines may lessen the visible symptoms – which yes, looks good for Instagram – but takes away the effectiveness of a biological protector. Alcohol flushing is the perfect example of a double-edged sword.
While suggestions like using green-tinted primer and foundation to minimize the red splotches or taking full advantage of Instagram filters seem more feasible than alternatives that require chemically altering your body’s release of histamine, the ease of taking a small pill over the labor that might come with other solutions to alcohol flushing is something to be acknowledged. Antihistamines are an appealing solution in the short term to avoid alcohol flushing, especially to stay afloat the binge-drinking culture of college; yet in the long run you may be wishing you never started drinking – that is, unless you’re here for a good time, not a long time. So take pictures before you take a sip of that beer and party in the dark. Remember, everything in moderation, including moderation itself.