For quick adjustment of image brightness during skin imaging with reflectance confocal microscopy, an adaptive brightness adjustment method was proposed. The association between laser power control voltage and image brightness was established by experiments. Images can have two types of brightness: extreme and moderate. Using segmental adjustment, brightness of the initial image could be quickly changed from extreme to moderate. Finally, the optimal brightness was obtained using linear compensation. Real-time imaging of skin tissues at different depths and locations can show if the initial image is too bright, too dark, or of moderate brightness. Subsequently, quick adjustment of the brightness can be achieved. The number of iterations is 2-3, and the optimal image brightness is approximately 70. The results show that this method is fast and can effectively meet the needs of skin imaging with reflectance confocal microscopy.