Asian flush is a genetic disorder that causes some people of Asian descent to have a flushed face after consuming alcohol. It is caused by faulty or slow-working ALDH enzymes, leading to a buildup of acetaldehyde in the liver. There is no cure, but symptoms can be avoided by abstaining from alcohol consumption. Repeated episodes can lead to health complications.
“Asian flush” is a term applied to a genetic disorder that causes some people of Asian descent to grow flushed in the face after consuming alcohol. Symptoms of the disorder can be as mild as a clear red glow, much like severe flushing, or as severe as narrowed airways and an elevated heart rate. In 2009, up to half of East Asians, especially those who trace their heritage to China, Taiwan, Japan and Korea, were estimated to have inherited the genetic defect that causes the so-called Asian hot flash.
There is no cure for Asian color, also called the “Asian glow” or “Asian feel” in some contexts. As long as those affected abstain from alcohol consumption, however, there are no symptoms. The flushing is solely caused by an inability to process the alcohol and poses no other health problems.
Under normal circumstances, the human body breaks down alcohol through a two-step metabolic process in the liver. Alcohol dehydrogenase enzymes, also known as ADH enzymes, break down alcohol into acetaldehyde. The body’s aldehyde dehydrogenase enzymes, or ALDH enzymes, then convert that acetaldehyde into acetic acid, which can be easily absorbed and eliminated from the body.
People who are affected by the Asian flush typically have difficulty with the second phase of the metabolic process. Their ALDH enzymes are faulty or work very slowly. This causes the alcohol in their bodies to only partially break down, leading to a buildup of acetaldehyde in the liver. This buildup is what causes the flushed face characteristic of the Asian flush.
The slow reaction time of ALDH is the result of a genetic disorder in nearly all cases. A person with Asian hot flashes carries genes that code for an inactive ALDH enzyme. This means that the person still produces ALDH, but that the enzyme is unable to metabolise alcohol, or does so very ineffectively.
In most people, there are two genes responsible for ALDH and other metabolic enzymes. It is very common for only one of these genes to be defective. People who have inherited just one faulty gene often show mild symptoms of alcohol flushes, often no more than a brief flush of the normally pale Asian complexion and a mild headache. Two faulty genes usually cause more extreme alcoholic reactions, such as nausea, vein constriction and airway constriction. Many doctors warn that repeated episodes of Asian hot flashes can lead to heart complications, blood pressure problems or even esophageal cancer in some cases.
The extent of a person’s symptoms is often as much a factor in the genetic defect as is overall alcohol consumption. Even a person with just one problem gene can experience a severe reaction if multiple drinks are consumed, particularly in a short period of time. For those affected, the only way to avoid symptoms that are at best embarrassing and at worst quite dangerous is to avoid alcoholic beverages, or commit to enjoying them only in the utmost moderation.
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