Acres of Skin: Albert Kligman and the Human Experiments at Holmesburg Prison

The dermatologist Albert Kligman made his first visit to Holmesburg Prison in Philadelphia in 1951 to treat an outbreak of athlete’s foot among the inmate population. By his own account, his reaction to the prison yard was not clinical or professional. He looked at the men assembled there and thought about what he was looking at. He later described that first impression in terms that have been quoted in nearly every account of what followed: “All I saw before me were acres of skin.”

For the next twenty-three years, until federal regulations finally ended the practice of conducting medical experiments in prisons, Kligman used Holmesburg as a laboratory. He tested pharmaceuticals, cosmetics, radioactive isotopes, LSD, dioxin (a highly toxic component of Agent Orange), chemical warfare agents, and experimental vaccines for viruses including herpes simplex and human papillomavirus on the incarcerated men of Holmesburg. His corporate clients included Johnson and Johnson, Dow Chemical, and dozens of other pharmaceutical and cosmetics companies. He held contracts with the United States Army. He generated millions of dollars in research income for the University of Pennsylvania.

He won awards. He was honoured with named lectureships and professorships. He died in 2010 still celebrated as a pioneer of dermatology, the inventor of Retin-A, one of the most important figures in his field’s history. None of these things is inaccurate. Neither is what he did at Holmesburg.

The Prison and the Population

Holmesburg was a Philadelphia municipal prison that housed a population that was predominantly Black, predominantly poor, and in many cases awaiting trial, held in pre-trial detention because they could not afford bail. The men Kligman recruited as research subjects were offered small payments, sometimes as little as a dollar a day for participation in experiments that lasted weeks or months and that in some cases left lasting physical effects. The money was the primary incentive. In the context of prison life, where commissary access, family support, and bail funds were constant preoccupations, the small sums Kligman paid were not trivial.

The consent forms the men signed, when consent forms were used at all, frequently did not describe the compounds being tested or the potential risks. Forms for the dioxin experiments, for which Kligman received $10,000 from Dow Chemical, did not name dioxin. Forms for chemical warfare experiments conducted under a contract with the United States Army did not identify the compounds as potential weapons. Men signed forms saying they were participating in skin tests and received chemical agents capable of causing serious neurological harm.

Formal ethical review of research protocols did not become a federal requirement in the United States until the early 1970s, and many of Kligman’s experiments at Holmesburg predated that requirement. But the Nuremberg Code, which established the principles of voluntary consent and the necessity of disclosing the nature and risks of research to subjects, had been in existence since 1947. Kligman was aware of it; he had been practicing medicine since the 1940s and had trained during the period when its principles were being widely discussed. His experiments at Holmesburg violated those principles whether or not formal institutional review was required.

What Was Actually Done

The experiments at Holmesburg were not a single program. They were dozens of separate studies conducted over more than two decades for a variety of clients with a variety of purposes. Some were relatively routine pharmaceutical trials testing whether skin preparations caused irritation. Others were not routine at all.

Approximately seventy-five prisoners were exposed to high doses of dioxin as part of the Dow Chemical contract. Dioxin is a potent carcinogen and the compound responsible for Agent Orange’s toxicity to humans. Some participants experienced severe inflammation that lasted weeks and eliminated their willingness to continue. Their objections were documented and the experiment continued.

Under a separate contract with the United States Army, worth approximately $386,000, Kligman and a colleague conducted chemical warfare research at Holmesburg, seeking to determine the minimum effective dose of agents capable of mentally disabling half of any given population, what researchers called the MED-50. Around 320 men participated in this program. The psychoactive compounds used included agents that the Army was interested in as potential incapacitating weapons. Participants were not told what they were receiving or that the research had military applications.

Children with intellectual disabilities were infected with fungal infections of the scalp as part of other experimental work. Elderly patients from nursing homes were used in experiments related to aging of skin. The common thread was a consistent failure to ensure that the people participating in Kligman’s research understood what they were participating in and had freely chosen to do so.

The Reckoning, Such As It Was

The Philadelphia Inquirer published investigative reporting on the Holmesburg experiments in the late 1970s and early 1980s that brought the story to public attention. By then the experiments had been over for years; federal regulations restricting medical experimentation on prisoners had come into effect in the mid-1970s, partly as a consequence of the broader public response to the Tuskegee study revelation in 1972.

Nearly 300 former Holmesburg prisoners who attributed ongoing health problems to Kligman’s experiments filed a lawsuit against him, the University of Pennsylvania, and Johnson and Johnson. The suit was dismissed in 2000 under the statute of limitations; the period within which claims could have been brought had long since passed.

The University of Pennsylvania stripped Kligman’s name from an annual lecture series and a named professorship in 2021, following sustained advocacy by researchers and community members who had spent years documenting the experiments. The College of Physicians of Philadelphia apologised for its own silence on the matter in January 2023. The City of Philadelphia issued a formal apology in October 2022.

Kligman never apologised. In interviews, he maintained that the experiments had been conducted within the ethical norms of their era. Allen Hornblum, the researcher whose book “Acres of Skin” first brought comprehensive documentation of the Holmesburg experiments to a general audience, spent years interviewing survivors and found that claim difficult to reconcile with what men described happening to their bodies and what they had and had not been told about what was being done to them.

TL;DR: Key Facts and Why This Case Matters

Who was Albert Kligman?

Albert Kligman (1916–2010) was a professor of dermatology at the University of Pennsylvania Medical School and the inventor of Retin-A, widely regarded as one of the most significant contributions to modern dermatology. Between 1951 and 1974, he conducted medical experiments on prisoners at Holmesburg Prison in Philadelphia, testing pharmaceutical products, cosmetic compounds, radioactive isotopes, LSD, dioxin, and chemical warfare agents on a population that was predominantly Black and in many cases pre-trial detainees who had been unable to post bail.

Who were the research subjects?

Holmesburg’s prisoner population was predominantly Black and predominantly poor. Participants were offered small payments that were meaningful incentives in the context of prison economics. Consent forms frequently did not describe the compounds being tested or the potential risks. Forms for some experiments did not name the compounds at all. Men signed forms describing skin tests and received chemical agents with serious toxic potential.

What were the legal consequences?

Nearly 300 former prisoners filed civil suits against Kligman, the University of Pennsylvania, and Johnson and Johnson for harm caused by the experiments. The suit was dismissed in 2000 under the statute of limitations. No criminal charges were ever brought. Formal institutional apologies from the University of Pennsylvania, the College of Physicians of Philadelphia, and the City of Philadelphia were issued between 2021 and 2023.

Why does this case matter?

The Holmesburg experiments represent a sustained violation of research ethics principles across more than two decades, conducted by a prestigious academic physician at a major research university with funding from government agencies and major corporations. They illustrate how incarcerated populations, lacking the practical ability to refuse participation or access independent legal counsel, are uniquely vulnerable to research exploitation. They also illustrate how professional achievement and institutional standing can continue to be honoured long after the practices that contributed to them have been documented as harmful. The belated institutional apologies of 2021 to 2023 came more than fifty years after the last experiment at Holmesburg was conducted.