Remember to NOT do FILE > SAVE. Use SAVE AS to reclaim space. If that doesn't work, fix the blemishes FIRST (before OCR).
The type of editing you are talking about is the appearance. If you use searchable text form of OCR, you can not change the look, only the text behind the look. To be able to edit the blemishes and such, you have to use ClearScan for the OCR. Then the text on screen is what you get, not behind an image. The rest is changed into a collection of images that you can now select and remove. Still care needs to be used as the object selection often selects more than you think it would.