If there are social cows in life, there will be social anxiety. There is a kind of social anxiety that occurs at a young age but instantly loses control during communication with others: cheeks suddenly turn red and hot, and fine beads of sweat ooze from the forehead... The physical distress becomes even more apparent, and the feeling of being tightly locked in by everyone's gaze creates a huge sense of anxiety that leads to social avoidance. be careful! This is beyond the scope of introverted personality and is likely a dual psychological and physiological problem - agoraphobia. This type of social anxiety is characterized by a "red face and heartbeat" fear of facial flushing, medically known as "facial flushing fear". It refers to the appearance of obvious flushing on the face and even the whole body in public or specific social situations, and due to the patient's excessive focus on their own reactions, strong anxiety emotions arise. This anxiety is like a vicious cycle vortex, plunging patients into deeper social avoidance quagmires, exacerbating their feelings of loneliness and social barriers. The core symptom of red face phobia is facial flushing, accompanied by physiological manifestations such as sweating, rapid heartbeat, shortness of breath, hand tremors, and even dizziness or nausea; Psychological manifestations include obvious anxiety and tension, low self-evaluation, fear of being watched or evaluated by others, social avoidance, and repeated recollection of awkward situations. Physiologically speaking, deep facial flushing caused by the combination of physical and mental factors is a normal stress response in the human body, often due to the excitation of the sympathetic nervous system in the head and face. During adolescence or early adulthood, many people experience this under social pressure. But when this reaction seriously interferes with daily life, work, and social interactions, it may have entered the realm of agoraphobia. The pathogenesis of agoraphobia covers two dimensions: psychological and physiological. At the psychological level, patients often have excessive concerns about social situations or are influenced by past negative social experiences, overly focusing on and caring about others' evaluations, and experiencing internal conflicts and confrontations - one side sticks to their shy and timid personality, while the other side crazily forces themselves to change. Physiological genetic factors to some extent affect an individual's susceptibility to social anxiety; Excessive excitation of the sympathetic nervous system and increased sensitivity of some patients' facial blood vessels to emotional stimuli can lead to flushing reactions during tension or anxiety. Adopting multiple measures to alleviate facial flushing type social anxiety lifestyle reshaping, mastering relaxation techniques such as deep breathing and meditation, relaxing tense nerves, and relieving anxiety; Stay away from stimulating foods such as coffee and spicy food, which may exacerbate facial flushing. Psychological therapy tackles cognitive behavioral therapy: listening to patients' voices, providing encouragement and understanding, helping to relieve stress, and building confidence; Change patients' negative perceptions of social situations, help them establish more positive social beliefs, and reduce excessive attention to physiological reactions. Exposure therapy: gradually expose patients to social situations that trigger anxiety, from low stress to high stress, helping them adapt and reduce fear. Drug therapy assisted with anti anxiety drugs: such as selective selection of serotonin reuptake inhibitors to alleviate anxiety caused by nerve conduction abnormalities and reduce the frequency of facial flushing. Beta blockers: alleviate symptoms of rapid heartbeat and sweating caused by anxiety, but are usually used as short-term adjuvant therapy. It should be noted that all drug treatments should be carried out with caution under the professional guidance of a doctor, and the dosage and course of treatment should be finely adjusted according to the severity of the condition to ensure both safety and efficacy. Surgical treatment breakthroughs include thoracoscopic sympathectomy, which is currently a minimally invasive technique for treating hemiphobia. Usually, under general anesthesia, a small incision is made under the patient's armpit to separate the sympathetic nerves on both sides of the incision segment. To give a simple analogy, surgery is like cutting off the line that delivers "current" to the face, and the "red face signal light" is turned off. The surgery is short in time, minimally invasive, and has a definite effect. Surgical treatment is suitable for patients who have poor conservative treatment outcomes, are intolerant to medication related side effects, or have difficulty bearing the medical costs of long-term treatment. The surgical effect is immediately visible after surgery, and patients can quickly feel an improvement in facial flushing and sweating. However, some patients may bear the risk of compensatory sweating after surgery - the sweat that was originally supposed to be on the face is now transferred to body parts such as the back, chest, and legs, and this compensatory sweating is sometimes more obvious. (Xinhua News Agency) by Zhou Ting and Zhu Weipeng (Beijing Tsinghua Chang Gung Hospital)