By Missy Clifton, MD
Jeuveau (prabotulinumtoxinA-xvfs, Evolus, Inc.) received approval from the U.S. Food and Drug Administration (FDA) on February 1, 2019, for the temporary improvement in the appearance of moderate-to-severe glabellar lines. PrabotulinumtoxinA (PBoNT/A) is a proprietary 900-kDa purified botulinum toxin type A formulation for the temporary improvement in the appearance of moderate-to-severe glabellar lines.
Jeuveau differentiates itself from other neuromodulators on the market beginning with its manufacturing process, which combines vacuum-dried processing with proprietary Hi-Pure technology, allowing the purification of the toxin with at least 95% purity.1
While some treatments use freeze-drying, Jeuveau’s vacuum-drying avoids crystal formation and minimizes product impurities, maintaining the integrity of the toxin and reducing the risk of antibody formation.2
In a head-to-head study against Botox Cosmetic, Jeuveau demonstrated non-inferiority in the treatment of moderate-to-severe glabellar lines in adults and achieved a higher responder rate at Day 30 (87.2% vs. 82.8%, respectively). In the same study, Jeuveau was numerically favored in 26/30 exploratory endpoints.3 In a recent double-blind clinical trial comparing the effects of four different neurotoxins, Jeuveau showed a fast onset, long-lasting effects, and long-term efficacy.4 For this study, 143 women were randomized 1:1:1:1 into four treatment arms: one dose of onabotulinum toxin A (OBoNT/A), one dose of abobotulinum toxin A (ABoNT/A), one dose of PBoNT/A, or one dose of incobotulinum toxin A (IBoNT/A) into the glabellar region (GR). ABoNT/A and PBoNT/A had the fastest onset at Day 3. PBoNT/A and IBoNT/A retained efficacy at Day 180 compared with their baseline. Increasing the baseline glabellar strain severity resulted in increased improvement with treatment, and lateral canthal region strain increased with decreasing GR strain, the study showed. PBoNT/A was significantly more effective at Day 180 than OBoNT/A. All arms experienced improvement in related FACE-Q Aesthetics module scores up to 90 days.
From the patient perspective, this formula has led to many reported benefits,
including5:
- Fast-acting results, as quickly as two days following injection.
- Long-lasting results, up to four months.
Evolus does not utilize a reimbursement model. The Company’s cash-pay model offers increased transparency and control. Consumers don’t have to worry about unexpected out-of-pocket expenses.
In my experience, Jeuveau’s unique formula allows patients to see more natural results faster, that last longer. I look forward to the continued growth of Jeuveau and seeing how Evolus’ focus on cash-pay aesthetics supports the company’s continued growth.
ABOUT THE AUTHOR
Missy Clifton, MD, is a Dermatologist and the Founder of Premier Dermatology in Bentonville, AK.
DISCLOSURES
Missy Clifton, MD, is a trainer for Evolus, Inc. and a member of the Company’s advisory board.
References
- Jeuveau® [package insert]. Evolus, Inc.; 2023.
- Avelar R. Botulinum toxin accessory proteins: Are they just an accessory? Dermatol Surg. 2024;50(9S):S38–S41. https://pubmed.ncbi.nlm.nih.gov/38864825/
- Rzany BJ, Ascher B, Avelar RL, et al. A multicenter, randomized, double-blind, placebo-controlled, single-dose, phase 3, non-inferiority study comparing prabotulinumtoxinA and onabotulinumtoxinA for the treatment of moderate to severe glabellar lines in adult patients. Aesthet Surg J. 2020;40(4):413–429. https://pubmed.ncbi.nlm.nih.gov/30951166/
- Lemdani MS, Honig SE, Habarth-Morales TE, et al. Comparison of botulinum toxin a formulations for glabellar
strain treatment in women: A double-blind randomized clinical trial. JAMA Dermatol. 2025;161(7):723–730. https://pubmed.ncbi.nlm.nih.gov/40434770/ - Saxon MD Facial Plastic Surgery. Jeuveau vs Botox: What’s the Difference? Available at: https://saxonmd.com/blog/jeuveau-vs-botox/#:~:text=Personal%20Experience%20with%20Jeuveau,of%20looking%20overdone%20or%20frozen. Accessed July 18, 2025.
