The iconic cameo is made by engraving an image into an object, most commonly the conch shell. Conch shells carve very well, but their color fades over time. It nearly always features a raised image, usually a woman in white, against a coral orange background, better known as a relief image. The intaglio image is cut into the background of the shell. These are very rare and takes a master skills man to produce. There are few cameo makers because it is one of the hardest challenges for any gemstone carver.
Besides carving into a shell, the agate stone is also popular for carving cameos. Agate is micro-crystalline quartz. It is popular because of its durability, compared to the conch shell. Ancient Greek and Roman jewelers carved cameos out of agate, while the Italians were known for their shell cameos. The oldest agate cameo found dates back to around 200 B.C. Although agate gemstones come in a variety of colors, blue is the most popular. Carving the white into the different layers allows for interesting shadows to enhance features of the image.
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Check out this video for more information: https://www.youtube.com/watch?v=63CFHOmi81E