The hyaluronic acid filler category has an image problem. After months of looking themselves in the mirror, pharmaceutical companies are ready to chart its comeback.
Across the board, headlines in 2024 and 2025 reported that people were experiencing filler fatigue and either dissolving their fillers, pushing off appointments, or were otherwise uninterested in getting fillers to begin with. The aversion to fillers coincided with the resurgence of “natural-looking” makeup and “undetectable” procedures, which came to the forefront of culture, renouncing the now derided “Instagram face.”
Giants like Allergan Aesthetics, Waldencast and Evolus are deploying a series of tactics ranging from unbranded reports, eschewing the term “filler” and targeting GLP-1 patients in hopes of correcting misinformation, changing perception and ultimately rebolstering sales.
Macroeconomic factors have also eroded their bottom lines. At a Sept. conference with Morgan Stanley, Allergan’s owner AbbVie noted that US consumers earning less than $150,000 per year often deferred or skipped treatments. The average price paid for a hyaluronic acid treatment in 2024 was $1,437, compared to neurotoxins at $893, according to a January 2025 report from healthcare intelligence firm Guidepoint Qsight. AbbVie’s filler brand Juvéderm saw its net revenue decrease 24 percent year-on-year, and the company lowered its 2025 guidance.
Between 2019 and 2022, the number of patients receiving HA fillers (including brands Juvéderm, Voluma, Volbella, and the Restylane portfolio) increased by 70 percent, according to the American Society of Plastic Surgeons; by 2024, however, the number of new procedures has levelled out.
“We’ve come into the era where filler has baselined,” said Cece Davis, a board-certified nurse practitioner and injector at SkinSpirit. “We know what these products are capable of doing in excess and also in [less than] appropriate amounts and we’re now finding that sweet spot for patients.”
Despite multiple quarters of sales slowdown, new entrants have also emerged in the HA filler space. In April, aesthetic pharmaceutical company Evolus launched its first HA filler brand Evolysse, followed in July by Milk Makeup owner Waldencast’s acquisition of medical aesthetics brand Novaestiq and the US rights to Saypha. Waldencast will market Saypha under its Obagi professional skincare line. Both companies see an opportunity to snap up market share and grow the overall category through a mix of innovative marketing, product technology and brand affinity.
Don’t Say the “F-Word”
When Evolus first debuted its Botox-competitor Juveau in 2019, the company embraced its positioning as a beauty product, something that pharmaceutical companies have hesitated to do. Juveau has since managed to capture 14 percent of neuromodulator market share in the US. With the HA filler category currently in flux, Evolus plans to use that as an opportunity to debut a disruptive approach.
Chief executive David Moatazedi said that when Evolus conducted its own patient research, they found that people felt negatively toward the word “filler” rather than actual products, which as a whole consist not only of hyaluronic acid injectables but also biostimulators like Galderma’s Sculptra.
“The word ‘filler’ has probably been overused, and there’s a perception that when you use the word filler, it evokes a negative response,” he said, “whereas hyaluronic acid or bio-stimulatory injectables don’t do that.”
Evolus sought to tweak the lexicon through a provider-focused campaign called Drop the F Word between April and Sept. 2025, which jettisoned “filler” in favour of “injectable hyaluronic acid.” Hyaluronic acid, a popular skincare ingredient that has been around for decades, has undergone its own rediscovery in the beauty industry since 2024, and the company learned that the term has more positive associations than filler. Moatazedi said Evolus plans to earn $700 million in annual total revenues by 2028, with HA fillers representing nearly 30 percent of total sales.
While Evolus may be embracing newer terminology, US beauty group Waldencast is hoping it can make the Obagi brand synonymous with HA fillers and relinquish the need for the term — like what Allergan once did with Botox.
After acquiring Novaestiq Corp for $3 million in cash (with earnouts tied to FDA approval milestones and sales thresholds), the company recently secured FDA approval for its injectable Saypha MagIQ for nasolabial folds in Sept. 2025, and plans to engage practitioners in December and consumers in the first quarter 2026.
Compared to maybe 50 competitors in the professional dermatology space, there are only six or seven in the HA filler category, Waldencast CEO Michel Brousset pointed out. Obagi already has marketing, field teams and supply chains established to serve medical offices, making it a lower lift to get off the ground.
“There are still millions of treatments happening with fillers, and as a consequence, is a fundamentally very attractive category [for] the Obagi brand with its medical history,” Brousset said, adding that the company hopes to add other aesthetic treatments under the brand name in the future. The company’s latest earnings reported a 10 percent revenue lift for Obagi in the third quarter, though it was weighed down by poor sales at flagship cosmetics brand Milk Makeup.
“Our objective is to be the first mega brand that spans skincare and aesthetics,” he said, adding that Obagi plans to add other aesthetics under the brand name in the future.
Filler’s Rising Tides
If Obagi is embracing its brand name to the full extent, Juvéderm’s strategy runs opposite: The brand hopes to restore shine to the term filler before pushing any particular brand.
In August, parent company Allergan published an unbranded report about the HA filler category, aimed at correcting misinformation about the safety and efficacy of the product and show that 97 percent of patients report high satisfaction with HA fillers.
Nicole Katz, Allergan’s VP of customer engagement and corporate affairs, said it was more appropriate to talk about the entire category rather than focus only on Juvéderm’s reputation. If you have an industry-wide problem, it doesn’t serve any one brand only to correct its own record, Katz said.
Allergan has distributed the report with providers, will present it at upcoming industry conferences and has repurposed information from the report for social media consumption. Notably, the report found that over two-thirds of consumers use social media as a trusted source to find out about dermal fillers. Allergan will evaluate success through consumer perception surveys, with the hope that it moves to neutral and positive.
“It’s puzzling that we’re having this issue in the marketplace because we see a high level of satisfaction for patients,” Katz said. “It tells you that the challenge is really getting them [in the medical office], and once they actually have the treatment, they’re really happy that they did it,” she said.
Dr. Terrence Keaney, a board-certified dermatologist who has consulted with Allergan on its report and provider training, said the report’s insights have already shaped how Allergan offers support to providers through its Allergan Medical Institute. Training now puts as much emphasis on patient communication as it does on injection technique, he said, and that Allergan is “learning how to better address patient hesitations with data and empathy.”
Nurse injector Davis perhaps summarised the new dynamic best.
Providers need to “have streamlined education across the entire industry … as opposed to everybody having a different answer for patients,” she said. “It’s not a patient’s job to know what a product is or what a product does.”
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