Asian party-goers strive to get rid of that 'glow' often caused by the first drink -!-!- Devon Haynie -!-!- 2007/04/24 -!-!- Their genes can make their faces turn red and fiery after one sip of alcohol. But the biology battle has begun. Asian-American youth across the country are turning to over-the-counter drugs to make the dreaded "Asian flush" a tint of the past. -!-!- Anthony Ho never knows what’s going to happen when he has his first sip of alcohol. But this is what sometimes occurs when he downs a beer, or two, or three: “I’ll get rosy in the cheeks, and then it gets exponential from there," said Ho, a 24-year-old Chinese-American who is a consultant in Washington. "My heart rate starts increasing, my breathing gets shallower. I get congested. It feels like my face is swollen, and I get really hot and hazy. Eventually, I’ll turn bright red and the veins will pop out of my forehead. I have a lot of physical indicators when I’m about to burst with color.” Ho suffers from what many Asian-Americans call the "Asian glow," an often uncomfortable and embarrassing reaction to alcohol. The glow--also called the Asian sensation, Asian explosion, Asian flush and Asian blush--can cause anything from a mild, pink facial tint to nausea and swelling in half of all east Asians, doctors say. The glow is genetic, and caused by an inability to metabolize alcohol, they say. There is no cure for the glow--no prescription pills to pop or liquid to swallow. And medical professionals acknowledge that they’re not too eager to find a remedy. But young adults may have stumbled on one already. Large numbers of Asian-American youth are turning to over-the-counter antacid medicines like Zantac and Pepcid AC to keep their alcohol-induced blushing at bay. Those who show signs of the Asian glow have inherited either one or two abnormal genes, said Dr. Adam Bisaga of the Columbia Medical Center in New York. When alcohol is first metabolized, it is converted to a byproduct known as acetaldehyde, Bisaga said. In most people, an enzyme known as aldehyde dehydrogenase 2 (ALDH2) breaks down acetaldehyde. Some Asian-Americans, however, have a deficiency in the enzyme, which causes them to break down acetaldehyde at a much slower rate. When acetaldehyde accumulates in the bloodstream, it can cause flushing, burning or other unpleasant side effects, doctors say. The severity and symptoms of the Asian glow vary. People who have two of the mutant genes might turn bright purple, sweat, have a rapid pulse rate and feel sick, while others with one abnormal gene may only occasionally experience mild side effects, like a slight red tint or faint burning sensation, Bisaga said. “I never really think about it,” said Billy Sountornsorn, a 25-year-old Asian-Australian in Washington who turns red occasionally after several beers. “I get it, but it’s not that bad. It usually just feels like I’m in the sun or in a really hot subway car.” Although Asian glow is a relatively minor nuisance for many, some Asian-Americans say it can often put a serious damper on their social life. Ho, whose red face is now a regular fixture at many Washington parties, said that his unease about his post-libation complexion often prevented him from drinking in college. “I was self-conscious about it at first,” Ho said. “I was the butt of every joke. And it just wasn’t physically comfortable.” Although an official remedy for Asian glow doesn’t exist, Asian-Americans are finding creative ways to mitigate the symptoms. Some line their stomachs with food in the hope that they will absorb less alcohol--some believe potatoes or other starchy foods work best. Ho, Sun and Sountornsorn, however, say that by far the most common way of fighting the glow is through over-the-counter antacid drugs, particularly Zantac and Pepcid AC. "I don't know how valid Pepcid AC is, but it's probably true," said Marilla, a 20-year-old Chinese-American college student in New York who asked that her last name not be used because she cannot drink legally yet. "I've taken two pills before I've gone out. It's worked for me. I don't turn as red." Marilla and others say they heard of the Pepcid AC “cure” from their friends and through Wikipedia, the Web-based encyclopedia, which has an entry on alcohol flush reaction. Although they have little idea how it works, many swear by the results. Doctors, however, are skeptical. “The Pepcid stuff, this is all anecdotal,” said Bisaga, a psychiatrist who specializes in alcohol addiction. "It’s not been studied much, though. I don’t give it much credit.” Bill Pearse, a spokesman for Pepcid AC, said he was unable to comment on whether the product might be effective in combating the Asian flush. Pepcid AC has "not been intended to use in that regard," Pearse said. “We're only able to provide information about maladies [Pepcid AC] is intended for. I'm not familiar with any studies in that regard." Dr. Tamara Wall, a professor of psychiatry at the University of California at San Diego, speculates that the histamine blockers in Pepcid AC and other antacids may prevent the blushing associated with the Asian flush. But the medicines, she said, likely have "no direct role in lowering acetaldehyde" in the blood. So even if the Asian glow goes away, people can still experience nausea, shallow breathing and other symptoms. Wall said she had also heard about herbal cures in Asia, but doubted they were completely effective. Even if there were a cure, she said doctors would not rush to find it. Bisaga, for example, believes there is a benefit to the Asian glow. “Most people believe that [the Asian glow] is one of the reasons that alcoholism is much less prevalent in eastern Asia,” he said. “It serves as a protective factor. The rate of alcoholism among eastern Asians is about 10 to 20 percent of what it is in the Western world.” Bisaga and Ho also warned that it was particularly dangerous for eastern Asians who experience the Asian glow to drink large quantities of alcohol. They are more likely to die from excessive alcohol consumption, Wall said. And east Asians with increased acetaldehyde levels and abnormal genes may be at a greater risk of developing different liver diseases, head and neck cancer and other symptoms typically associated with long-term alcohol abuse. "When you take things like Pepcid AC, it might mask the flush," Wall said. "But while you can drink more because you're not embarrassed by the flush, you may still be exposed to the toxic effects of drinking." As far as Bisaga is concerned, young adults with the Asian glow should stay as far away from alcohol as possible. “It’s usually good to listen to your body when these things happen,” he warned. “Your body is often much smarter than your brain.” E-mail: