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Botulinum Toxin Market Size, Share & COVID-19 Impact Analysis, By Application {Therapeutic (Chronic Migraine, Spasticity, Overactive Bladder, Cervical Dystonia, Blepharospasm, Others) and Aesthetics}; By Type (Botulinum Toxin Type A and Botulinum Toxin Type B); By End User (Specialty & Dermatology Clinics, Hospitals & Clinics, and Others), and Regional Forecast, 2021-2028

Region : Global | Format: PDF | Report ID: FBI100996



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The global botulinum toxin market size was USD 3.20 billion in 2020. The market is projected to grow from USD 3.41 billion in 2021 to USD 5.68 billion by 2028 at a CAGR of 7.6% in the 2021-2028 period. The global impact of COVID-19 has been unprecedented and staggering, with botulinum toxin witnessing a negative demand shock across all regions amid the pandemic. Based on our analysis, the global market exhibited a decline of -34.0% in 2020 as compared to the average year-on-year growth during 2017-2019. The sudden fall in CAGR is attributable to this market’s demand and growth, returning to pre-pandemic levels once the pandemic is over.

Botulinum toxin is produced by Clostridium botulinum, a gram-positive anaerobic bacterium. Seven different types of antigenically different but structurally similar botulism toxins are available in A, B, C, D, E, F, and G forms. The product now plays a very significant role in the management of a wide variety of medical conditions. Commercially available forms include Toxin A and Toxin B.

The major factors that fuel the market growth are the surge in demand for cosmetic non-invasive surgical procedures, new product launches, increasing affordability, and amendments in reimbursement policies to cover botulinum injections. Leading key players in this market are focusing on constant innovation and up-gradation of their product portfolio for better aesthetic and improved therapeutic outcomes for the patients.

  • For instance, in February 2021, AbbVie received FDA approval of Botox for the treatment of detrusor overactivity associated with a neurological condition in certain pediatric patients of 5 years of age and older.

Moreover, the increasing importance of aesthetic beauty, further driven by increasing therapeutic applications of these toxins for critical and chronic diseases, is likely to drive the market growth during the forecast period.

Increasing Number of Hospitalization during COVID-19 to Augment Demand

The impact of COVID-19 is clearly visible in the healthcare sector as it is at the epicenter of this unprecedented global pandemic challenge. The COVID-19 pandemic has negatively affected the sales of botulinum toxin products across the globe due to reduced demand in both therapeutic and aesthetic applications. Strictly imposed lockdowns, ban on elective procedures, and disruptions in the supply chain are the major identifiable factors responsible for the reduced demand.

  • For instance, according to the American Society of Plastic Surgeons (ASPS) data, the total number of Botox type A procedures decreased from 5.04 million in 2019 to 4.40 million in 2020, and it observed a decline of 12.7% in procedures.

However, some of the therapeutic indications where stopping treatment would result in the need for urgent critical care or accessing emergency departments have been treated with this protein. Hence, the rising demand for this toxin for the treatment of critical conditions has continued.

Major players in the market reported a decline in the revenue from neurotoxin preparations in the 2020 financial year. For instance, Allergan, a strong player in the market, recorded a decrease of 33.1% and 34.8% of revenue in 2020 compared to last year for ‘Botox Cosmetic’ and ‘Botox Therapeutic,’ respectively. Other companies such as Revance Therapeutics, Inc. and IPSEN Pharma have also reported a decline in revenues of these products in 2020 owing to the closure of treatment centers.


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Increasing R&D Initiatives and Growing Number of Therapeutic and Aesthetic Indications to Drive Growth

Botox has several therapeutic and aesthetic indications, and this dual applicability in terms of indications is anticipated to drive the market growth. Its application in treating several critical and chronic diseases such as chronic migraine, spasticity, and cervical dystonia is anticipated to contribute to the positive market growth. In terms of therapeutics, this toxin is estimated to have hundreds of potential indications and currently, more than 100 therapeutic uses of these toxins are reimbursed by healthcare providers. Given the increasing therapeutic applications, key market players are investing heavily in their research and development for product launches. This is anticipated to offer wide opportunities for global market growth in the future.

  • For instance, in 2020, Revance Therapeutics, Inc. spent USD 125.8 million in research and development, which was increased by 22.3% from USD 102.9 million in 2019.

Additionally, several players are disclosing the result of their clinical trials. This is projected to offer extensive opportunities for players to strengthen their market position in the upcoming years.

  • For instance, in January 2019, Ipsen Pharma announced its leadership in botulinum toxin research with a strong presence (abobotulinumtoxinA (Dysport) and its recombinant product pipeline at the 2019 TOXINS International Conference.

Therefore, the increasing R&D initiatives by the key market players in order to launch and market therapeutic botox products are offering lucrative market growth opportunities in the near future.


Surge in Demand of Minimally-invasive Cosmetic Procedures to Boost Market Expansion

The high demand for cosmetic surgeries and minimally invasive or non-invasive procedures, such as botulinum toxin and facial filler injections, has increased tremendously over the past decade.

  • According to the International Society of Aesthetic and Plastic Surgery, the total number of non-invasive procedures, including this toxin, hyaluronic acid, laser hair removal, among others, increased by 7.6% during 2018-2019, from 12,659,146 procedures in 2018 to 13,618,735 procedures in 2019.

  • Furthermore, there is a gradual rise in the number of people inclined towards botulinum toxin procedures. According to the International Society of Aesthetic and Plastic Surgery, the total number of procedures increased by 2.9% during 2018-2019, from 6,097,516 procedures in 2018 to 6,271,488 procedures in 2019.

The surge in the demand for this technique has also led to a significant impact on the suppliers of dermatological preparations and other non-invasive technologies. Various pharmaceutical companies involved in this field are increasingly launching products to meet the increasing demand for these products.

  • For example, in June 2019, Huons Global, a South Korean company, introduced a botulinum neurotoxin brand called ‘Liztox’ in the Korean market for the treatment of glabellar lines, it is effective in both moderate and severe glabellar wrinkles.


High Cost and Relative Side Effects of Botulinum Toxin to Decline Market Growth

Despite various therapeutic and aesthetic applications, various side effects of these products are projected to hamper the global market size in the upcoming years. The possible adverse effects include pain, swelling or bruising at the injection site, headache or flu-like symptoms, droopy eyelid or cockeyed eyebrows, crooked smile or drooling, and eye dryness or excessive tearing.

Additionally, The high cost of these products is one of the key restraints declining the botulinum toxin market growth. For instance, the average price of botox (100 Unit Vial) for the treatment of spasticity is USD 437 in the U.S. (North America) and USD 907 in Brazil.


By Application Analysis

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Increasing Number of Clinical Trials to Expand Therapeutic Applications to Drive Segmental Growth

On the basis of application, the market segments include therapeutics (chronic migraine, spasticity, overactive bladder, cervical dystonia, blepharospasm, and others), and aesthetics.

The therapeutic segment dominated the market in 2020. The dominance is primarily attributed to the heavy investments for extensive research and development of therapeutic products and its expanding applications in various disease categories.

  • For instance, in June 2020, Teijin Pharma Limited received approval from Japan’s Ministry of Health, Labor and Welfare (MHLW) to market Xeomin (incobotulinumtoxinA) for intramuscular injection in 50, 100, or 200 units for the treatment of upper limb spasticity.

On the other hand, the growing importance of looking beautiful due to increasing penetration of social media and the internet has resulted in increased demand for non-invasive procedures for cosmetic applications which is likely to drive the aesthetics segment growth.

By Type Analysis

Botulinum Toxin Type A to Dominate Backed by a Large Number of Product Approvals

Based on type, the market is categorized into type A and type B.

Among them, the type A segment held a dominating share in 2020. The dominance of the segment is attributable to a large number of products available in the market with therapeutic and aesthetic applications. Moreover, type A injection is the most common cosmetic procedure performed globally. Surveys from core aesthetic specialty organizations consistently rank it first on the list of member-reported, nonsurgical aesthetic procedures.

Additionally, the higher share of the segment is attributed to the larger number of product offerings compared to type B and wider therapeutic and aesthetic applications of type A.

  • For instance, in February 2019, Evolus, Inc. received the USFDA approval for Jeuveau (Type A injection) for the temporary improvement in the appearance of moderate to severe glabellar lines associated with corrugator and/or procerus muscle activity in adults.

The type B segment is anticipated to expand at the high growth rate during the forecast period owing to the expansion of the therapeutic indication chronic sialorrhea, possible approval of the product in merging regions, and growing research and development to study other possible therapeutic uses of the Myobloc. For instance, in August 2019, US WorldMeds, LLC announced that the U.S. FDA approved MyoBloc (rimabotulinumtoxinB) injection for the treatment of chronic sialorrhea

By End User Analysis

Specialty & Dermatology Clinics to Grow with the Highest CAGR during Forecast Period

On the basis of end user, the market segments include specialty & dermatology clinics, hospitals & clinics, and others.

Among them, the specialty and dermatology clinics segment accounted for the highest botulinum toxin market share. A higher number of non-invasive cosmetic procedures is conducted in specialty and dermatological clinics compared to regular hospitals. This is the major factor for the growth of this segment. Furthermore, the rising prevalence of chronic diseases and aesthetic problems such as frown lines, glabellar lines, and crow’s feet is expected to favor the expansion of the segment.

On the other hand, the hospitals and clinics segment held the second largest share in 2020 owing to the initiation of the increasing number of Botox procedures being conducted in hospitals and clinics. For instance, according to the American Society for Aesthetic Plastic Surgery, out of 6,271,488 botulinum toxin procedures conducted worldwide in 2019, around 40% of them were performed in hospitals.


North America Botulinum Toxin Market Size, 2020 (USD billion)

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Geographically, the market in North America dominated with a size of USD 2.15 billion in 2020 owing to the highly aware and economically stable population along with a comparatively higher number of procedures performed in the region. For instance, according to the International Society of Aesthetic Plastic Surgery, in 2019, about 1.3 million procedures were performed in the U.S. Growing number of non-invasive cosmetic procedures and increasing new product approvals for wide therapeutic indications are poised to drive the market growth during the forecast period.

Europe captured the second-largest share of the market, attributable to the increasing preference among individuals for undergoing botox surgeries in key European countries and rising expenditure on research and development in Europe. For instance, according to a study conducted in the U.K., women who rated their self-esteem, life satisfaction, and attractiveness as low, had few religious beliefs, and had high media exposure were more likely to undergo botox surgery.

Asia Pacific region is poised to witness a higher demand for non-invasive aesthetic procedures due to increasing per capita disposable income and high preference given to Asian countries for medical tourism. According to the International Society of Aesthetic Plastic Surgery (ISAPS) annual Global Aesthetic Survey, medical tourism for cosmetic procedures in Thailand is increasing and more than 33.2% of cosmetic surgery patients were from foreign countries.

In Latin America, the number of botulinum injection procedures is estimated to be high, especially in Brazil, and in the Middle East & Africa, the number of botulinum injection procedures are estimated to increase. Increasing per capita spending on healthcare, growing health and beauty standards, medical tourism in Brazil, Mexico, and other emerging economies of Latin America, and the growing penetration of players in these regions are likely to boost revenue growth.


AbbVie Inc. and Ipsen Pharma to Lead Global Market with Strong Product Offerings and Global Reach

The current global market for this toxin is consolidated owing to the strong portfolio and diverse product offerings by major players. AbbVie Inc., Ipsen Pharma, and Merz Pharma are among the leading players in this market. A well-established brand presence and a strong distribution channel have been instrumental in the success of these players in the market.

  • For instance, AbbVie Inc. (Allergan) has always emphasized expanding its production plants and focusing on R&D in order to maintain or improve its market position. For instance, in January 2020, Allergan opened a new R&D-based plant in Ireland.

Other market players include Revance Therapeutics, Inc., Medytox, USWM, LLC. (US WorldMeds LLC), GALDERMA, Lanzhou Institute of Biological Products Co., Ltd., and HUGEL, Inc.


  • AbbVie Inc. (Lake Bluff, U.S.)

  • Ipsen Pharma (Paris, France)

  • Revance Therapeutics, Inc. (California, U.S.)

  • Merz Pharma (Frankfurt, Germany)

  • Medytox (Cheongju-si, South Korea)

  • USWM, LLC. (Kentucky, U.S.)

  • GALDERMA (Lausanne, Switzerland)

  • Lanzhou Institute of Biological Products Co., Ltd. (Gansu, China)

  • HUGEL, Inc. (Seoul, Republic of Korea)


  • May 2020 – AbbVie Inc. Inc., completed the acquisition of Allergan with a view to strengthen its position as a strong leader in many therapeutic categories.

  • July 2020 – Teijin pharma receives marketing approval for Xeomin in Japan. Tenjin Pharama and Merz Pharma are in partnerships for pharma sales in Japan. Xeomin is useful in treatment of lower limb spasticity, it will be useful for treatment of post stroke spasticity patients. Due to this, Teijin Pharma will perform Merz Pharma’s Xeomin sales in Japan.


An Infographic Representation of Botulinum Toxin Market

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The global botulinum toxin market report provides a detailed analysis of the market and focuses on key aspects such as leading companies, application, type, and end users. Besides this, it offers insights into the market trends and highlights key industry developments. In addition to the aforementioned factors, the report encompasses several factors that have contributed to the growth of the advanced market over recent years.

Report Scope & Segmentation



Study Period


Base Year


Estimated Year


Forecast Period


Historical Period



Value (USD billion)


Application;  Type;  End User; and Region

By Application

  • Therapeutics

    • Chronic Migraine

    • Spasticity

    • Overactive Bladder

    • Cervical Dystonia

    • Blepharospasm

    • Others

  • Aesthetics

By Type

  • Botulinum Toxin Type A

  • Botulinum Toxin Type B

By End User

  • Specialty & Dermatology Clinics

  • Hospitals & Clinics

  • Others

By Geography

  • North America (U.S. and Canada)

  • Europe (U.K., Germany, France, Italy, Spain, Scandinavia, Russia, Turkey, Austria, Switzerland, and Rest of Europe)

  • Asia Pacific (Japan, China, India, Australia, Southeast Asia, and Rest of Asia Pacific)

  • Latin America (Brazil, Mexico, and Rest of Latin America)

  • Middle East & Africa (South Africa, GCC and Rest of Middle East & Africa)

Frequently Asked Questions

Fortune Business Insights says that the global market stood at USD 3.20 billion in 2020 and is projected to reach USD 5.68 billion by 2028.

In 2020, the North America market value stood at USD 2.15 billion.

The market will exhibit steady growth at a CAGR of 7.6% during the forecast period (2021-2028).

Among application, the therapeutics segment will lead the market.

Surge in the demand of minimally-invasive cosmetic procedures and increasing R&D initiatives are the key drivers of the market.

AbbVie Inc., Ipsen Pharma, and Merz Pharma are the top players in the market.

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