What Causes Flushed Cheeks After Drinking Alcohol?

The technical term for experiencing facial flushing immediately after drinking alcohol is alcohol flush reaction.

Alcohol flush reaction is also sometimes referred to as Asian flush syndrome, Asian flush, or Asian glow because of the approximately 36% of East Asians (Japanese, Chinese, and Koreans) that exhibit such facial flushing after drinking alcohol.

Two tattooed friends at rooftop party drinking cocktails
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Symptoms

The degree of symptoms varies from person to person, but generally, symptoms of alcohol flush reaction include:

  • Developing flushes or blotches associated with erythema (superficial reddening of the skin caused by dilatation of the blood capillaries, usually in patches).
  • Nausea
  • Headaches
  • Rapid heart rate
  • Missing out on the buzzed feeling usually experienced after drinking alcohol

Alcohol flush reaction can occur on:

  • The face
  • The neck
  • Shoulders
  • In some cases, the entire body

Causes

After consuming alcohol, an enzyme called alcohol dehydrogenase (ADH) converts alcohol into acetaldehyde, a toxin that is the byproduct of metabolized alcohol. Another enzyme called aldehyde dehydrogenase 2 (ALDH2) then metabolizes acetaldehyde into a less harmful substance called acetate.

Facial flushing is a reaction that occurs in people with a genetic mutation that may alter the activity of the enzyme ALDH2. A deficiency in the ALDH2 enzyme means that acetaldehyde builds up in the body, which results in the release of histamine—the chemical involved in allergic reactions—causing flushing and other symptoms such as increased heart rate and nausea.

Is Facial Flushing Dangerous?

In studies, alcohol flush reaction has been associated with lower than average rates of alcoholism (possibly due to the association with adverse effects after drinking alcohol) and the dilated capillaries and flushed cheeks are of themselves a painless reaction. However, alcohol flush reaction is a condition that has been associated with an increased risk of esophageal cancer in those who drink.

Ways to Delay Facial Flushing

It is not possible to replace the ALDH2 enzyme, though there are many marketed drinks and potions that claim to help you metabolize acetaldehyde. In order to prevent alcohol flush reaction you must change your drinking habits with a few simple ways:

  • Eating a meal before drinking alcohol may slow down the metabolism of alcohol in your system by reducing the buildup of acetaldehyde and preventing alcohol flush reaction.
  • Not drinking more than one alcoholic drink per hour and drinking slowly. This allows your body to flush out the acetaldehyde, especially if you guzzle water in between alcoholic beverages.
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Cho Y, Kwak S, Lewis SJ, et al. Exploring the utility of alcohol flushing as an instrumental variable for alcohol intake in Koreans. Sci Rep. 2018;8(1):458. doi:10.1038/s41598-017-18856-z

  2. National Health Service. Facial Flushing.

  3. Edenberg HJ, Mcclintick JN. Alcohol Dehydrogenases, Aldehyde Dehydrogenases, and Alcohol Use Disorders: A Critical Review. Alcohol Clin Exp Res. 2018;42(12):2281-2297. doi:10.1111/acer.13904

  4. Peng Y, Shi H, Qi XB, et al. The ADH1B Arg47His polymorphism in east Asian populations and expansion of rice domestication in history. BMC Evol Biol. 2010;10:15. doi:10.1186/1471-2148-10-15

  5. Abbas G, Krasna M. Overview of esophageal cancerAnn Cardiothorac Surg. 2017;6(2):131–136. doi:10.21037/acs.2017.03.03

By Heather L. Brannon, MD
Heather L. Brannon, MD, is a family practice physician in Mauldin, South Carolina. She has been in practice for over 20 years.