Q: What are the pros and cons of Jeuveau?

Pros Jeuveau injections can temporarily soften facial lines, like forehead wrinkles and crow’s feet, that are caused by repetitive muscle movement. Relaxing these muscles can also help prevent new wrinkles. Pain is minimal, with a brief sting from the injections that fades quickly. You won’t have downtime—just a little redness (and minor bruising, possibly) at the injection sites. A 2019 study published in Dermatologic Surgery shows that results start to appear within two days. Results aren’t permanent, so if you don’t like them, they’ll gradually fade. Some reviewers say that Jeuveau doesn’t feel as “heavy” as its competitors. It’s safe for all skin types and tones. Cons As with any injectable toxin, you’ll need follow-up treatments a few times a year to maintain your results. Not all providers offer Jeuveau, so it may be hard to find. Unlike Botox, Jeuveau isn’t FDA approved for treating medical conditions like hyperhidrosis, facial spasms, and migraines. It can be used off-label for those purposes, but health insurance won't cover it. According to its manufacturer, Evolus , the most common side effects of Jeuveau include headache, a drooping eyelid, upper respiratory infection, and increased white blood cell count. Learn more about potential side effects .

Question 1

What is Jeuveau?

Accepted Answer

Jeuveau (prabotulinumtoxinA-xvfs) is an FDA-approved injectable treatment that temporarily smooths moderate to severe glabellar lines, the frown lines between the eyebrows also known as “elevens.” It's also used off-label to treat lateral brow lines, bunny lines (from crinkling the nose), chin wrinkles, crow’s feet, a gummy smile, lip lines, and neck bands, according to Dr. Sheryl Clark, a board-certified dermatologist in New York City.

Sometimes marketed as Newtox, this “purified” form of botulinum toxin A has a molecular weight similar to Botox, with similar risks and side effects.

When injected, Jeuveau relaxes (and at higher doses, paralyzes) the facial muscles of expression. By keeping muscles from making repeated movements, it helps prevent fine lines from forming and softens facial wrinkles that have already made their mark.

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Question 2

Jeuveau vs. Botox: What’s the difference?

Accepted Answer

Jeuveau and Botox are both forms of botulinum toxin type A. However, some doctors and reviewers on RealSelf have noted a few differences—one being that Jeuveau seems to kick in a few days earlier.

What’s more, Dr. Clark adds, “Patients have shared the impression that it comes on and wears off very naturally.”

Related: Jeuveau vs. Botox: I Tried Both, and Here's My Honest Review

Question 3

What are the pros and cons of Jeuveau?

Accepted Answer

Pros

Jeuveau injections can temporarily soften facial lines, like forehead wrinkles and crow’s feet, that are caused by repetitive muscle movement.
Relaxing these muscles can also help prevent new wrinkles.
Pain is minimal, with a brief sting from the injections that fades quickly.
You won’t have downtime—just a little redness (and minor bruising, possibly) at the injection sites.
A 2019 study published in Dermatologic Surgery shows that results start to appear within two days.
Results aren’t permanent, so if you don’t like them, they’ll gradually fade.
Some reviewers say that Jeuveau doesn’t feel as “heavy” as its competitors.
It’s safe for all skin types and tones.

Cons

As with any injectable toxin, you’ll need follow-up treatments a few times a year to maintain your results.
Not all providers offer Jeuveau, so it may be hard to find.
Unlike Botox, Jeuveau isn’t FDA approved for treating medical conditions like hyperhidrosis, facial spasms, and migraines. It can be used off-label for those purposes, but health insurance won't cover it.
According to its manufacturer, Evolus, the most common side effects of Jeuveau include headache, a drooping eyelid, upper respiratory infection, and increased white blood cell count. Learn more about potential side effects.

Question 4

How much does Jeuveau cost?

Accepted Answer

Jeuveau costs between $8 and $20 per unit. Your total treatment price will depend on:

Your provider’s credentials and level of experience: A treatment from a physician assistant or registered nurse injector may cost less than one from a board-certified dermatologist or plastic surgeon. More experienced providers also usually charge more for their expertise.
Their practice location: Providers in high-rent areas typically have to charge more.
How many units you get: Some injectors price neuromodulator treatments by the treatment area, but most charge by the unit. In general, the more product you need, the more you will pay. So if you’re treating multiple areas, broader areas (the full forehead versus the glabella between the eyes), or larger, stronger muscles that require higher doses (like the masseters), you can expect a larger bill.
Special offers or discounts: Sometimes providers offer promotional pricing for a limited time or discounted prices for multiple Jeuveau treatments. Additionally, Evolus, the manufacturer of Jeuveau, may offer rebates.

Jeuveau is considered an elective cosmetic treatment, so insurance doesn’t cover it, but many practices offer monthly payment plans.

Question 5

Jeuveau before and after pictures

Accepted Answer

The Jeuveau photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.

Question 6

What happens during a Jeuveau treatment?

Accepted Answer

Jeuveau injections are best administered in a doctor’s office by a physician, PA, or highly trained nurse injector.

It’s a short appointment that doesn’t require anesthesia. Injectors use tiny needles (often the same kind used by diabetics to inject their daily insulin), but if you’re pain-sensitive, a topical numbing agent or ice can help minimize the pinch.
The treatment area will be thoroughly disinfected.
Your injector will analyze your muscle patterns and areas of concern by having you furrow, pout, raise your brows, smile, and make other expressions.
Your doctor will mark injection points and then make strategic injections into the muscles. To treat the glabellar lines, for instance, they’ll inject over each eyebrow and in between the eyebrows to temporarily block communication between your nerves and the wrinkle-causing muscles.

There isn’t any downtime after treatment, but you may have some localized tenderness, swelling, bleeding, or bruising associated with the injection.

Follow your injector's recommendations for aftercare. Many advise against these activities for up to 24 hours post-treatment:

bending over or lying flat after neurotoxin treatment due to the possibility of the product migrating, leading to side effects like eyelid drooping
strenuous exercise
alcohol consumption
excessive heat exposure

Question 7

How long does Jeuveau take to kick in?

Accepted Answer

Your muscles will start to relax within 2 days, but it can take a week or longer to see full results. (That’s a bit faster than Botox, which can take up to 2 weeks to fully take effect.)

It’s not uncommon for patients to return to their doctors 10 days post-treatment to “see the effects and tweak the treatment plan to optimize future treatments,” says Dr. Clark. Occasionally, they’ll add units to perfect the results.

Related: The Treatments and Ingredients Actually Proven to Reduce Wrinkles

Question 8

How long does Jeuveau last?

Accepted Answer

Jeuveau lasts 4 months, on average, according to clinical trials, while Botox lasts 3 to 4 months.

Longevity can vary by patient and dose. “The higher the dose, the longer it lasts—up to a point,” notes Dr. Clark.

Question 9

If you’re immune to Botox, will Jeuveau work?

Accepted Answer

“Botox and the other neurotoxins may become less effective over time in some patients,” says Dr. Steven Goldman, a plastic surgeon in Beachwood, Ohio. “One theory is that antibodies build up, neutralizing the Botox before it gets to the nerve ending.”

Doctors on RealSelf say that the only way to know if Jeuveau will work for you as a Botox alternative is to try it. Each of the neuromodulators has slight differences in its chemical makeup, so it’s possible Jeuveau will work if your body has stopped responding to others.

In Dr. Goldman’s experience, however, “switching to a different brand of botulinum toxin usually doesn't make this problem go away. In general, patients will require higher doses [at greater expense]—and the toxin effect won't last as long, even at higher doses. Nonetheless, trying Jeuveau is reasonable.”

Question 10

Jeuveau side effects

Accepted Answer

As with any injection, potential side effects include pain, bleeding, bruising, redness, swelling, tenderness, and infection.

In Jeuveau clinical trials, some patients also reported headaches, eyelid drooping, upper respiratory infection, and an increased white blood cell count were all reported.

Rarely, patients experience allergic reactions marked by itching, rash, welts, wheezing, and trouble breathing. However, this treatment is safe for those who have an egg allergy or a dairy allergy. The protein it contains is human serum albumin, derived from human plasma, which is different from the albumen protein found in egg whites and milk.

Question 11

What are the alternatives?

Accepted Answer

Botox Cosmetic is the most popular form of botulinum type A. It has a wide range of FDA-approved cosmetic uses, including softening frown lines, forehead wrinkles, neck bands, smile lines, and smoker’s lines. It’s also medically approved for a variety of medical indications, including excessive sweating and migraines.

Dysport is another form of botulinum toxin. The injection process and longevity are similar to those of its competitors, but Dysport reportedly kicks in a bit sooner than Botox. Upon injection, Dysport has been known to spread more than the other substances—which, in skilled hands, can mean a more natural-looking result and, in less-practiced hands, could lead to an increased chance of drooping eyelids or brows.

Xeomin is another popular alternative for reducing the appearance of lines and wrinkles. Xeomin contains only the active core molecule of botulinum toxin A, minus any complexing proteins. For this reason, Xeomin proponents believe the body is less likely to develop a resistance to it.

Daxxify, the newest neuromodulator on the U.S. market, contains a novel peptide purported to help it to last longer (up to six months, in most cases, according to company trials). The peptide also eliminates the need for human serum albumin, a stabilizer found in other neuromodulators. Since the product’s launch, however, many reviewers on RealSelf have complained that Daxxify doesn’t live up to its longer-lasting claims. Such dissatisfaction has contributed to the treatment’s unusually low Worth It Rating.

Related: What’s the Difference Between Botox, Dysport, Xeomin, and Jeuveau?

If you’re wary of toxins or needles, there are other effective treatment options for fine lines and wrinkles, including fillers, lasers, and ultrasound or radiofrequency energy treatments. A board-certified dermatologist or plastic surgeon can recommend the best one for your specific concerns and goals.

Question 12

Sources & studies

Accepted Answer

Beer, Kenneth R., et al. “Efficacy and Safety of PrabotulinumtoxinA for the Treatment ... : Dermatologic Surgery.” Dermatologic Surgery, 2019.

JEUVEAU

Sheryl D. Clark, MD

Julie Ricevuto

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	Jeuveau nonsurgical	Botox nonsurgical	Dysport nonsurgical	Xeomin nonsurgical
Worth It Rating	88%	97%	95%	95%
Average Cost	$346	$593	$453	$565
Downtime	No downtime	No downtime	No downtime	No downtime
Anesthesia	No anesthesia	No anesthesia	No anesthesia	No anesthesia

Sheryl D. Clark, MD

Julie Ricevuto

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