The photo below is a picture of my great grandfather. This photo was taken around 1910 (my best guess) making him about 20 years old. This first shot is right out of the camera; specs, scratches and all.
After spending between 10 and 15 minutes using only the healing brush in Photoshop Elements -- most of the specs and scratches are gone. The sepia tone remains, showing the age of this black and white image.
Converting the image to true black and white using Silver Efex Pro -- only adjusting contrast and brightness and it looks terrific to me. Not bad for a photo about 100 years old.