Congenital Insensitivity to Pain with Anhidrosis: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 2, 2026.
What kind of doctor treats Congenital Insensitivity to Pain with Anhidrosis?
A pediatrician or family doctor usually coordinates care, with specialists such as a neurologist, geneticist, and orthopedic doctor often involved. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What it is
Congenital insensitivity to pain with anhidrosis is a rare condition people are born with: "congenital" means present at birth, "insensitivity to pain" means pain cannot be felt normally, and "anhidrosis" means the body cannot sweat normally.
Often called CIPA, this rare genetic disease involves a gene change that damages the nerves carrying pain and temperature signals to the brain. The sweat glands also do not work properly.
Symptoms
The most well known sign is not feeling pain, a child might break a bone or get a deep cut without noticing. Because pain is the body's alarm system, injuries can go untreated. Children also cannot sweat much, so they overheat easily, and repeated high fevers are common in babies.
Causes and who gets it
CIPA is caused by a mutation in the NTRK1 gene, which helps nerve cells that sense pain and temperature survive. A child must inherit one changed copy of the gene from each parent; carriers usually have no symptoms.
How doctors diagnose it
Doctors suspect CIPA in a child with unexplained fevers, no sweating, and unnoticed injuries; genetic testing can confirm it.
Treatment
There is no cure. Treatment focuses on preventing injuries and treating problems quickly, with regular skin and dental checks and prompt care for broken bones. Caregivers learn to keep the child cool and watch for overheating.
When to see a doctor
See a doctor for repeated unexplained fevers, very little sweating, or no reaction to injuries. Seek emergency care for a suspected broken bone, deep wound, burn, infection signs, or overheating.
How a direct primary care or concierge doctor fits in
A direct primary care doctor is paid a flat monthly fee instead of billing insurance per visit; a concierge doctor works similarly but charges more. Smaller patient lists allow longer visits and easier access, which can help families needing frequent monitoring.
Common questions
Can people with CIPA feel anything at all?
Most people with CIPA can still feel touch, pressure, and vibration. The nerves that sense pain, hot temperatures, and cold do not work properly. Some people with the condition also have reduced sensation in parts of the skin.
Is CIPA the same as not feeling pain anywhere in the body?
People with CIPA generally cannot feel pain in the usual way, though the exact pattern can differ from person to person. Some may notice certain sensations in a limited way. Doctors evaluate each patient individually.
Why is not feeling pain dangerous?
Pain tells the body something is wrong. Without it, a person can break a bone, get a serious burn, or develop an infection without knowing. Injuries that go untreated can lead to lasting damage.
Can CIPA be cured?
There is no cure at this time. Care focuses on preventing injuries, watching the body closely, and treating problems early. How well a person does depends on many factors, and outcomes differ from person to person.
How common is CIPA?
CIPA is very rare. Only a small number of cases have been reported worldwide, though some researchers think milder cases may go undiagnosed.
Sources
- MedlinePlus - Congenital insensitivity to pain with anhidrosis
- NIH Genetic and Rare Diseases Information Center - Hereditary insensitivity to pain with anhidrosis
- MedlinePlus Genetics - NTRK1 gene
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
