Oriental Flushing Reflex: Alcohol is Racist

Alcohol is racist. It doesn’t treat people of different races equally. It discriminates against Asians. It’s often called the Asian or Oriental flushing reflex.

Oriental flushing reflex
Example of Asian flushing reaction.

A genetic intolerance to alcohol occurs most often among Asians. So it’s generally known as the Oriental flushing reflex. The term “flushing” refers to the bright reddening of the skin or flushing. This is from the dilation of the blood vessels. This occurs in the face, neck, shoulder. Sometimes it covers the entire body.

It’s traditionally called Oriental flushing reflex. Today, the term “Oriental” is in disfavor. So it’s often called Asian flushing reflex.


Those who suffer this condition quickly have various unpleasant physical reactions. They do so after drinking even small amounts of alcohol. In addition to flushing, they can have rapid breathing, and nausea. Also itching, drowsiness, strange sensations in the ears, and other symptoms.

The Asian flushing reflex is caused by poor breakdown of alcohol in the body. This is because of a buildup of acetaldehyde. That, in turn, results from low production an ALDH2 enzyme. The root cause is a variant of the ALDH2 gene (ALDH2*2).

The proportion of Asians who suffer the condition depends on their racial background. It can be as high as over 36% among Chinese, Japanese, and Koreans. The condition is less frequent among Indians and other Asians. It is about 3% among whites.  The Chinese expression “to be red faced” for being slightly high has a basis in fact.

Those with Asian flushing reflex have up to a 10-fold increased risk of oesophageal cancer. This is thought to result from the accumulation of acetaldehyde.

The prevalence of the reaction among Asians is often suggested as an explanation for the low rates of alcoholism. But there is no relationship between flushing and reported drinking patterns. Nor can it explain changes in drinking patterns over time or between generations.

More about the Asian or Oriental flushing reflex

Greaves, M. and Burova, E. Flushing: causes, investigation and clinical consequences.  J Euro Acad Derm Vener, 8(2), 91-100.

Johnson, R. The Flushing Response and Alcohol Use Among US Minorities. In: Spieler, D. (Ed.) Alcohol Use Among US Ethnic Minorities.

Kitano, H. Alcohol and the Asian American. In: Watts, T. and Wright, R. (Eds.) Alcoholism in Minorities.