Written by Karen Vieira, PhD MSM
Jeuveau (prabotulinumtoxinA) branded as #NEWTOX is the newest addition to the line-up of injectable medications based on botulinum toxin A, the same active ingredient used in the well-known product “Botox.”
Jeuveau earned approval from the FDA in 2019 for use in the cosmetic treatment of moderate to severe “frown lines.” These are the vertical wrinkles and creases between the eyebrows, also known as “glabellar lines.”
Some physicians may be using Jeuveau off-label (i.e. without FDA approval) for treating wrinkles in other areas of the face, such as:
- Crow’s feet. Creases and fine lines on the outer edge of the eyes
- Furrows appearing on the forehead with raised eyebrows
- Frown lines between the eyebrows
The characteristics of Jeuveau are almost identical to Botox since both are extracted from the same type of bacteria.
However, in a head-to-head study comparing Jeuveau to BOTOX® Cosmetic, both investigators and study participants rated Jeuveau as superior to BOTOX® Cosmetic. Though the results didn’t quite reach statistical significance, they did show that, at the very least, Jeuveau is not inferior to Botox® Cosmetic. Furthermore, similar to Dysport®, Jeuveau has a faster onset of action. It also has a softer, less stiff appearance than BOTOX® Cosmetic.
Jeuveau uses a technology called Hi-Pure. This means that during the manufacturing process they take additional steps to purify the product, thereby making it safer.
Jeuveau also is cheaper than Botox by about 25%.
Jeuveau is based on botulinum toxin A, a compound that is made naturally by a type of bacteria (Clostridium botulinum). This compound is a potent neurotoxin, producing a paralytic effect in muscles by blocking the connections between the muscles and the nerves that make them contract.
Since many types of facial wrinkles and creases are caused by tension on the skin from underlying muscles, Jeuveau is a natural choice for treating these wrinkles.
By paralyzing and relaxing these muscles, Jeuveau releases the tension on the skin, thereby reducing the wrinkles and creases and giving a smoother, more youthful appearance.
The effects of Jeuveau, like other botulinum toxin medications, are only temporary, so the treatments must be repeated when the effects wear off to maintain the youthful look.
Not all facial wrinkles are caused by muscle tension. Some are the result of age-related loss of the skin’s supporting structures – such as fat under the skin or the collagen-elastin support matrix – and the result of the unkind effects of gravity. Jeuveau will not help with these kinds of wrinkles. Your treating healthcare professional will help you to determine which areas are appropriate for Jeuveau treatments.
Jeuveau is intended for use in adults, age 18 and up.
You should not receive a Jeuveau treatment if you have a skin infection at the planned injection area.
Women who are or may be pregnant, or who are breastfeeding should not receive Jeuveau treatments.
Your healthcare professional will take a full medical history from you to ensure that there are no medical reasons that would conflict with receiving Jeuveau treatments.
While Jeuveau injections provide a non-invasive alternative to plastic surgery, there are some potential risks involved. Your treating professional will review these with you.
The most common adverse effects of a Jeuveau treatment are:
- Headache – occur in about 12% of people
- Drooping eyelids (ptosis) – 2%
- Upper respiratory tract infection (such as a common cold, or sinus infection) – 3%
- Elevated white blood cell count in the blood (this is usually of no consequence to your health and doesn’t cause symptoms) – 1%
There may also be some bleeding, bruising, swelling, or redness at the injection site following a treatment.
While rare, Jeuveau – like other botulinum toxin products – may spread from the site of injection to other parts of the body. This may cause serious and even life threatening side effects, such as:
- Muscle weakness in areas other than the treated skin
- Double vision
- Generalized muscle weakness
- Difficulty swallowing, speaking or breathing
- Urinary incontinence
- Allergic reaction (itching, hives, chest tightness, severe swelling)
Jeuveau may cause dryness of the eyes. Any eye pain, irritation, light sensitivity, or visual changes should be reported to a physician.
Jeuveau injections are performed in a doctor’s office, and no anesthesia is required. However, some injectors may use ice to numb the area, or may offer a topical or local anesthetic. Treatment takes only about 10-30 minutes.
The injections are done using a fine-gauge needle. The healthcare provider will cleanse the treatment area and then inject the medication into the targeted muscles.
It usually takes 3-5 injections to the area to complete the treatment.
Jeuveau treatments don’t involve any downtime, so most people can return to their usual daily activities immediately following a treatment. This is why Jeuveau treatments are sometimes referred to as “lunchtime facelifts.”
Ice can be applied to the treatment area to reduce any swelling or bruising, and makeup can be applied immediately after the treatment.
The healthcare provider will give you aftercare instructions after the procedure. However, a few precautions are generally appropriate for the rest of the day after having a Jeuveau treatment:
- Do not lie down directly on the treatment area for four hours
- Do not massage or apply heat to the area treated
- Avoid activities that cause flushing (such as sitting in a hot tub, exercising, or drinking alcohol)
The effects of Jeuveau are not permanent, so they will fade with time. The results generally last 3-6 months. As such, follow-up treatments are required 2-3 times a year to maintain the results.
In general, a Jeuveau treatment costs $400-600. The exact cost of the procedure will depend on a several factors:
- The amount of Jeuveau product used
- The number of areas injected
- Your geographic area
- The skill level and fee schedule of the injector
Cosmetic injections are seldom covered by health insurance. However, many doctors offer financing options and flexible payment plans to make this treatment more affordable. Many also offer treatment plans so that follow-up treatments are at a reduced cost.
- Evolus. (2019). Highlights of prescribing information: Jeuveau (prabotulinumtoxinA-xvfs) for injection. Retrieved from https://info.evolus.com/hubfs/Jeuveau_USPI.pdf
- Evolus. (2019). Jeuveau [product page]. Retrieved from https://jeuveau.evolus.com/
- Rzany, B., Ascher, B., Avelar, R., Bergdahl, J., Bertucci, V., Bodokh, I., et al. (2019). A multicenter, randomized, double-blind, placebo-controlled, single-dose, phase III, non-inferiority study comparing prabotulinumtoxinA and onabotulinumtoxinA for the treatment of moderate to severe glabellar lines in adult patients. Aesthetic Surgery Journal, sjz110. Retrieved from https://academic.oup.com/asj/advance-article/doi/10.1093/asj/sjz110/5428816