Ketcham entered the pornography business at age 18,[3] after answering an ad in the San Diego State University newspaper.

[5] In 2008, she signed a deal with Vivid Entertainment and Tristan Taormino to direct her own line of movies under the studio's sex education imprint, Vivid-Ed;[6] the first film was Penny Flame's Expert Guide to Handjobs,[7] and the second was Penny Flame's Expert Guide to Rough Sex.

[9] Ketcham has said that she originally intended to disrupt the process in order to gain publicity and increase marketability as a porn star, but that after the first five days of treatment, she began to have a change of heart.

Nine months into this period of abstinence, a friendship with a man who supported her recovery and attended "12-step" meetings with her became a committed, monogamous marriage.

[10][verification needed] Ketcham is an avid painter and sees it as a healthy activity for sex addiction, as well as a new source of income.