Born in New York City and raised in Chicago, Illinois, Akerstrom was the daughter of Elizabeth W. Watkins and Swedish immigrant Charles G.

[8] She acted in shows including Fanchon the Cricket, The Pearl of Savoy, The Hidden Hand,[9] Annette, the Dancing Girl (1889, her New York debut),[10] Renah, the Gipsey's Daughter, A Little Busybody (1891),[11] A Strange Marriage, Under the City Lights (1898), A Beautiful Slave, a Waif of London (1898), and A Bachelor's Housekeeper (1898).

[12] Akerstrom wrote several plays and sketches during her performing years, including Viola, the Street Singer (1886), Renah, the Gipsey's Daughter (1886), Annette the Dancing Girl (1889), Miss Rosa, A Pauper's Fortune (1893), Queen of the Arena (1893), A Woman's Vengeance (1895), The Story of a Crime (1895),[13] That Smith Gal, Little Busybody, The Egyptian Dancer, and The Doctor's Warm Reception (1901).

[15][16] A revival of Akerstrom's Miss Rosa, staged in the United Kingdom circa 1895, featured famed Wild West performer Annie Oakley in the title role, making her professional acting debut.

[9] Works by Akerstrom from this period included A Doctor by Courtesy; or, A Jolly Mixup (1906),[17] The Widow (1910), St. Elmo (1910),[18] The Plot (1910), An Election Episode (1910), Adventures; or, The Woman Hater (1910), Vashti; or, Until Death Do Us Part (1910), The Reckoning (1911), Mental Suggestion; or, Made in Germany (1911), Mrs. Murphy's Second Husband (1911), Natasha (1911), The Eleventh Hour; or, Two Sisters (1911), A Story of the Hills (1911), The Wager (1912), The Sultan's Daughter (1912), The Sultan's Favorite (1912), Sunshine (1912), Our New Girl (1912), The Red Mask (1913), Caught with the Goods (1915), Over the Hills to the Poor House (1921), The Haunted Fliver; or, What's the Answer (1935) and Call of the King (1938).