Why Does My Face Turn Red When I Drink Alcohol?

Drinking alcohol is associated with certain predictable effects, such as impaired coordination, diminished inhibitions, and a change in mood. For some people, alcohol has an additional effect. It causes the skin on their face to redden. If this has happened to you, you may have two main concerns: Why does my face turn red when I drink alcohol? and is this a sign of a health problem? 

Why Does my Face Turn Red?

The question, “Why does my face turn red when I drink alcohol?” has a few possible answers. 

The most common reason why this occurs is that you have inherited a genetic condition that impairs your body’s ability to metabolize alcohol. However, it can also occur due to the misuse of alcohol as well. Blood vessels tend to enlarge after prolonged alcohol abuse.

Here’s how the National Institute on Alcohol Abuse and Alcoholism (NIAAA) describes why your face turns red when you drink alcohol:

• When you drink alcohol, an enzyme in your body converts the alcohol to acetaldehyde, which is toxic.
• Once this occurs, another enzyme then converts the acetaldehyde into non-toxic molecules.
• If this second step fails to occur (which is what happens in people who have the genetic condition referred to above), the toxic acetaldehyde will cause your cells to release chemicals called histamines.
• Histamines can cause allergy-like symptoms, including watery eyes, runny nose, and facial flushing.

Although this condition involves symptoms that are similar to allergies, it is important to understand that most cases of face reddening are not evidence of an allergy to alcohol. The genetic condition is a form of alcohol intolerance, and the effect it produces is referred to by clinicians as alcohol flush reaction.

Alcohol flush reaction can also occur if you are taking certain medications or if you have a skin condition called rosacea. Medications that treat high cholesterol and diabetes are among the drugs that can cause a person to develop alcohol flush reaction when they drink.

Are Some People More Susceptible to Red Spots?

Reddening of the face when drinking is most common among people of East Asian descent. 

A 2009 study in the journal PLOS Medicine noted that more than one-third of people from the nations of China, Japan, North Korea, and South Korea have the genetic condition that causes alcohol flush reaction. 

However, although people of East Asian ancestry are more likely to have this condition, this does not mean that they are the only people who can develop it. The authors of the 2009 study estimate that among the general public, about 8% of people have this condition. Given the current global population of about 7.97 billion, this means that more than 630 million people may have this deficiency.

Rosacea can also cause alcohol flush reaction. The American Academy of Dermatology (AAD) reports that about 16 million Americans have rosacea. It is most common among people with fair skin, adults age 30-60, and menopausal women. 

Is Red Face From Drinking Alcohol Dangerous?

Once you’ve answered the question, “Why does my face turn red when I drink alcohol?” you may next want to know if this is a dangerous condition – and, if so, if it can be treated.

First, in terms of danger, alcohol face flush can be a warning sign. If your face turns red when you drink alcohol, and if this effect results from a genetic deficiency, then you may be in considerable danger if you continue to drink.

Earlier on this page, we mentioned that most cases of alcohol flush reaction are the result of a genetic condition that prevents a person’s body from converting acetaldehyde into non-toxic molecules that the body can safely process. 

Acetaldehyde is a known carcinogen. This means that if you have this genetic condition, and you continue to drink alcohol, you may have an elevated risk for developing certain types of cancer. A buildup of acetaldehyde appears to significantly increase a person’s risk for esophageal cancer and breast cancer.

What Can I Do About Red Face from Alcohol?

The best (and healthiest) way to respond to alcohol flush reaction is to stop drinking alcohol.

If your face has been turning red because you have been taking a certain medication, this effect should dissipate when you stop taking the medication. Of course, if you need to take this medication to manage a chronic condition, this will not be an option. 

The NIAAA notes that certain over-the-counter (OTC) medications may prevent the onset of face reddening among people who have the genetic condition that causes it. However, the NIAAA also emphasizes that these OTC medications do nothing to prevent the buildup of acetaldehyde. So if the OTC remedies reduce the amount of facial flushing, and this results in a person continuing to drink alcohol, the end result may be a significantly increased risk of cancer. 

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