Evolus says the U.S. botulinum toxin market is stabilizing after the 2024 pullback, expecting low-single-digit growth now with a return to mid-single-digit growth by 2027–2028.

Its new HA product, Evolysse, is gaining traction—now in about 3,000 U.S. clinics with positive injector feedback on efficiency, control and duration, supported by hands-on training for over 12,000 injectors, and the flagship Sculpt formulation is expected to be approved later this year.

Management raised its 2028 outlook to $450–$500 million in revenue with 13%–15% adjusted EBITDA, reiterated 2026 guidance of $327–$337 million, and is driving growth via Jeuveau+Evolysse bundling and international expansion.

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Evolus (NASDAQ:EOLS) executives said they are seeing signs of stabilization and improvement in the U.S. botulinum toxin market after a period of industry-wide pressure, while describing a slower recovery for dermal fillers amid changing consumer sentiment. Speaking at the Leerink Conference, CEO David Moatazedi, CFO Tatjana Mitchell, and Head of R&D Rui Avelar also outlined the company’s longer-term financial targets and recent commercial initiatives tied to its growing injectable portfolio.

Moatazedi said the company feels “a lot better” about the toxin market, citing improvement beginning in the fourth quarter and continuing into the first quarter. He framed last year’s slowdown as notable because, in his view, the aesthetics toxin category has only experienced three periods of negative growth in roughly 25 years: the 2008–2009 recession, COVID shutdowns, and last year’s pullback.

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According to Moatazedi, the 2024 downturn was driven largely by a middle-class consumer reducing discretionary spending amid higher costs and broader uncertainty. He said the slowdown was not isolated to a particular age group or practice setting, describing it as widespread across channels. He added that, as in prior downturns, consumers tended to stretch the intervals between treatments to extend the value of each dollar.

Moatazedi said the company’s current view aligns with low-single-digit market growth assumptions for toxins, with an internal expectation that the market could return to mid-single-digit growth in 2027 and 2028. He characterized Evolus’ stance as conservative versus historical rebounds, while noting that clinics and national accounts have been signing up for growth and expanding their footprints.

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Moatazedi said the filler market has been slower to recover than toxins, attributing some of the weakness—particularly in hyaluronic acid (HA) fillers—to negative sentiment around “overfilled” faces and a consumer preference for more natural-looking outcomes. He described the filler softness as a two-year cycle and said clinics have increasingly been messaging both the safety of HA and its ability to deliver natural results.

He highlighted Evolus’ “Drop the F Word” campaign tied to its Evolysse launch, which encourages clinics to avoid the word “filler” in favor of “injectable HA.” Moatazedi said he believes sentiment is beginning to turn in Europe, pointing to the U.K. as a market where HA trends are improving and potentially serving as a lead indicator for the U.S., which he said may be about a year behind.

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On GLP-1 weight-loss drugs, Moatazedi said aesthetic clinics are seeing and treating GLP-1 patients, but suggested the impact will take time to flow through because patients need to reach desired weight, identify clinics, and budget for treatments. He also noted that declining GLP-1 pricing could help alleviate some affordability constraints.

Avelar described Evolysse’s HA gel technology as being manufactured at near-freezing temperatures to preserve the natural HA structure. He said feedback during diligence and in practice has been consistent in several areas:

Efficiency: injectors report needing less product to achieve correction.

Forgiveness: the gel can be used more superficially with fewer issues versus some robust gels.

Control: practitioners report the ability to inject to an intended result without needing to under- or over-correct.

Duration: the company saw good duration in clinical trials, which Avelar said is also resonating in practice.

Moatazedi said Evolysse has performed well despite broader filler category declines, stating the launch would rank among top HA launches given the market environment. He said the product is currently in about 3,000 U.S. clinics and that Evolus plans a deliberate effort in the second quarter to expand adoption.

He also emphasized the company’s training infrastructure, saying Evolus conducted hands-on training for more than 12,000 injectors last year. Moatazedi said the company has learned that a second hands-on training session can be an inflection point in utilization as clinics gain confidence with the product.

Moatazedi said the company’s combination of Evolysse and Jeuveau is strategically important because Evolus historically competed as a single-product company. He described a bundling pilot in the fourth quarter that offered incentives tied to incremental growth across both product lines; the company rolled out a broader six-month program nationally in January, designed to mirror loyalty-style programs offered by larger competitors.

In discussing competitive dynamics, Moatazedi said clinics may have limited Jeuveau share due to portfolio economics with competitors, and that adding fillers helps “unlock” share opportunities. He said Evolus’ Jeuveau share within the clinics it serves is roughly 25%–30%, and he suggested that share is capped more by economics than by product performance. He also said the expanded portfolio is enabling access to larger clinics that prefer fewer vendor partnerships.

Looking ahead, Moatazedi said Evolus expects approval of Evolysse Sculpt later this year, calling it the flagship product in the line and noting mid-face is a more premium and technically challenging area. Mitchell added that Sculpt is expected to be the largest product in dollar revenue within the four-product filler line, potentially around 40% or higher. Management also referenced additional product flow after Sculpt, including “eyes next year” and “lips” thereafter.

Mitchell reiterated the company’s 2026 guidance of $327 million to $337 million in revenue, representing about 10% to 13% year-over-year growth. She said Evolus is guiding to low- to mid-single-digit adjusted EBITDA margins in 2026, noting the company was profitable in the fourth quarter and expects to build from there.

For 2028, Mitchell said Evolus revised its long-term outlook to $450 million to $500 million in revenue with 13% to 15% adjusted EBITDA margins. She described growth drivers across:

Jeuveau: currently at 14% U.S. share, with guidance assuming a move into the mid-teens.

Evolysse: expected to be 10%–12% of global revenue in 2026, with only two products (Form and Smooth) contributing at that time.

International expansion: international revenue nearly doubled in 2025 and moved from 5% to 8% of total revenue; the company expects international to reach about 15% of revenue by 2028.

Mitchell said the company “rebased” expenses in 2025 as it built commercial infrastructure for the filler launch, and she expects operating leverage going forward without a similar step-up in operating expense. Moatazedi also highlighted Evolus’ consumer loyalty program, which he said has grown to more than 1.4 million consumers and is co-branded with clinics, including automated reminders and credits designed to bring patients back to the same practice.

Internationally, management said Evolus has a direct presence in the U.K., Germany, Spain, and Italy, with France served through partner Symatese; it is also direct in Australia and partnered in Canada. Moatazedi said the European toxin market has continued to grow at mid-single digits and that international markets did not experience the same economic pressure seen in the U.S. He estimated that the markets in which Evolus operates represent close to a $2 billion opportunity outside the U.S. across toxin and filler, and that the company’s combined share across those markets remains in the low single digits.

Evolus, Inc is a specialty pharmaceutical company focused on medical aesthetics. Headquartered in Newport Beach, California, Evolus develops and commercializes products designed to enhance facial appearance through minimally invasive procedures. Since its founding in 2017, the company has positioned itself in the fast-growing aesthetic market by partnering with leading manufacturers and leveraging clinical expertise to bring innovative injectables to practitioners and patients.

The company's flagship offering, Jeuveau (prabotulinumtoxinA-xvfs), is a neuromodulator approved by the U.S.

The article "Evolus Sees Toxin Market Stabilizing, Evolysse Gaining Traction, Raises 2028 Revenue Targets at Conference" was originally published by MarketBeat.