No, it does not necessarily need to be making contact with the skin. The istihbab is in the wearing of such stones, and even having them on you is of benefit as well.
Quranic verses in Sura Yousuf are the strongest evidence in this matter.
Prophet Yousuf told his brothers: Take this shirt of mine and cast it on the face of my father, he will turn clear-sighted. (12:93).
'We have many authentic narrations on the blessings which can be obtained by touching (Masah) of blessed items like Black stone, Zareeh of most humble servants of Allah, Quranic text, etc.
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