Abstract Digitalization provides adolescents with a variety of ways to entertain and socialize, but the new media environment may pose certain risks to their mental health. The paper expounds the relationship between social media exposure and social appearance anxiety, as well as the mediating role of social comparison. It also would enhance media health literacy as a potential solution. The aim is to clarify the formation mechanism of social appearance anxiety among adolescents in the digital media environment and provide governance recommendations to reduce social appearance anxiety among adolescents, so as to better help adolescents to resist risks and grow up healthy in the digital age.